Issue release date: 12.11.2024
Turkish Neurosurgery
1999 , Vol 9 , Num 3-4
THE SURGICAL ANATOMY OF SIX VARIATIONS OF THE EXTREME LATERAL APPROACH
1The Abant İzzet Baysal University, Medical School of Düzce, Deparhnent of Neurosurgey, Düzce, Türkiye2The George Washington University Medical Center, Department of Neurological Surgery, Washington DC, USA The extreme lateral transcondylar approach (ELA) is used to access lesions that are located or extend superior to the middle elivus, inferior to the upper cervical spine, and lateral to the foramina jugulare. Different combinations of drilling of several bone structures, including the occipital condyle, the C1 and C2 facets and laminae, and the jugular tuberele and process, coupled with suboccipital craniotomy, equip the surgeon with different ways of approaching the region of interest. In order to fully understand the options for ELA, it is useful to c1arify the variations of this approach. This study involved the bilateral use of 10 complete cadaveric head specimens and includes the description and discussion of six different variations of ELA relative to lesion location and the need for subsequent occipito-cervical fusion. The ELA options are as follows:
1. Retrocondylar approach (RCA)
2. Partial transcondylar approach (PTCA)
3. Transtubercular approach (TIA)
4. Transcondylar approach (TCA)
5. Transjugular approach (TJA)
6. Transfacetal approach (TFA)