The Use of an Anterior Approach to Ventrally Placed Tumors in the Foramen Magnum and Vertebral Column

Mullan, Sean; Naunton, Ralph F.; Hekmatpanah, Javad; Vailati, Giovanni

doi:10.3171/jns.1966.24.2.0536

Cited by 155 publications

(34 citation statements)

References 3 publications

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“…However, all have been developed using two basic anterior midline routes, the transnasal and the transoral [20,21]. Anterior approaches to the cervical vertebral junction and clivus were originally proposed for the treatment of vertebrobasilar aneurysms [22,23] or neoplasms [24]. Anterior access route includes the transseptal-transsphenoidal, transmaxillary, transpalatal and transoral-transpalatal, transmandibular, transmaxillary-transnasal, and the facial translocation approaches [25][26][27][28][29][30][31].…”

Section: Discussionmentioning

confidence: 99%

The anatomic study of clival screw fixation for the craniovertebral region

Wang

et al. 2012

Eur Spine J

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Purpose To study the anatomic parameters related to clival screw and establish reference data concerning the craniovertebral fixation technique. Methods Morphometric measurement of the clivus and the surrounding anatomic structures were obtained on 41 dry bone specimens. Then, 2-D CT reconstruction of the craniovertebral region of 30 patients (19 men and 11 women, ranging in age from 20-64 years with an average age of 38.8 years) were performed to measure the safety range for a 3.5-mm screw placement. Nine entry points were evaluated. Finally, one male fresh cadaver specimen (age 46 years) was dissected to observe the craniovertebral region. Results The clivus faces the basilar artery, the V * XII cranial nerves, the pons, and ventral medulla oblongata at its intracranial surface. The longitudinal diameter of extracranial clivus was 25.87 ± 2.64 mm. The narrowest diameter of the clivus was 12.84 ± 1.08 mm, the distance between the left and right hypoglossal canal was 32.70 ± 2.09 mm at its widest part. The distance between the left and right structures, the maximum value was 49.31 ± 4.16 mm at carotid canal, the minimum value was 16.54 ± 2.04 mm at the occipital condyle. The measurement of clival screws placement simulation via 2-D CT reconstruction images shows the maximum upper insertion angle of three components the optimal entry points, the candidate points, the limit entry points was 130.19°, 125.23°and 85.72°, and the total mean screw length was 7.57, 10.13 and 15.6 mm at the vertical entry angle, respectively. Conclusions Clival screw placement is a viable option for craniovertebral fixation. There is a safe scope for the screw length and angle of the screw placement. And, these parameters obtained in the present study will be helpful for anyone contemplating the use of clival screw fixation.

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Section: Discussionmentioning

confidence: 99%

The anatomic study of clival screw fixation for the craniovertebral region

Wang

et al. 2012

Eur Spine J

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“…Reduction by skeletal traction and fusion or halo-®xation would achieve spinal stabilization, and sometimes surgical intervention relieves the cord compression. 7 Mayo clinic statistics of 145 patients with myeloma disclosed involvement of C1 in four and of C2 in seven. Usually the tumour is in the articular mass of the atlas and the body of axis below odontoid.…”

Section: Discussionmentioning

confidence: 99%

Plasmacytoma of Dens as a cause of Atlanto-axial instability

1998

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“…3,4,6 In parallel work with colleagues at the University of Chicago's federally funded Argonne Cancer Research Hospital, he devised and tested a series of surgical approaches to treat cancers of the head, neck, and spine by inserting radioactive coils, wires, or needles directly into or around a tumor, a technique he later applied to create precise lesions in spinal tracts for pain management. 13 He was also a leader in developing and popularizing the transoral approach for surgical problems located at the base of the skull, 15 and he reported results of thalamic lesioning as a treatment for epilepsy in humans. 19 He used statistical tools to predict outcome after craniocerebral injuries, 2 an approach ushering in widely used grading and risk stratification in neurosurgery.…”

Section: Relentless Innovations and Impactmentioning

confidence: 99%