Abstract
Lesions placed anterior to the neuraxis are best approached anteriorly to minimize traction and further trauma on what may well be an already compromized structure. Although this concept is applied regularly in most spinal pathology, there has been understandable reluctance to apply this principle to pathology of the clivus, craniocervical junction, and upper hvo cervical vertebrae. The advent of microsurgical techniques, instruments designed specifically for transoral approaches (in particular), improvements in critical care and anesthesia, and perhaps most important, modern imaging have facilitated an anterior approach.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Olivera E, Rhoton AL, Peace D: Microsurgical anatomy of the region of the foramen magnum. Surg Neurol 24:293–352, 1985.
Lang J: Craniocenical region, surgical anatomy. Neuroorthopaedics 3:1–26, 1987.
Koksel T, Crockard HA: “Cli,us” through the eyes of the transoral surgeon. Turk Ncurosurg 1:146–150, 1990.
Crockard HA, Johnston F: Development of transoral approaches to lesions of the skull base and craniocervical junction. Neurosurg Q 3 (2):61–82,1993.
Hunter JV, Stevens J, Kendall BE, et al: Radiological assessment for transural surgery in rheumatoid arthritis, using dynamic CT myelography. Neuroradiology 33(suppl):413–415, 1991.
Hadley MN, Spetzler RF, Sonntag VK: The transoral approach to the superior cervical spine: a review of 53 cases of extradural cenicomedullary compression. Neurosurgery 71: 16–23, 1989.
Calder I: Anesthesia for transoral surgery and craniocervical surgery. In Jewkes D (ed): Balliere’s Clinical Anaesthesiology. London, Saunders, 1987, pp 441–457.
Crockard HA, Calder I, Ransford AO: One stage transoral decompression and posterior fixation in rheumatoid atlantoaxial subluxation: a technical note. J Bone Joint Surg [Brl] 72:682–685, 1990.
James D, Crockard HA: Surgical access to the base of the skull and upper cenical spine by extended maxillotomy. Neurosurgery 29:411–416,1991.
Spetzler RF, Selman WR, Nash CL: Transoral microsurgical removal, odontoid resection and spinal cord monitoring. Spine 4:506–510, 1979.
Crockard HA: The transoral approach to the base of the brain and upper cenical cord. Ann R Coli Surg Engl 67:321–325, 1985.
Crockard HA: Transoral surgery: some lessons learned. Br J Neurosurg 9:283–293, 1995.
Louis R: Chirugia anteriore del rachide cervicale superiore. Chir Organi Mov 77:75–80, 1992.
Von Grumppenburg S, Harms J: Aketue Technische Konzepte in der Wirbelsaulenchirugie Indikation und Technik der Osteosynthese bei Halswirbelsaulenverletzungen. Chirurg 63:849–855, 1992.
Menzes AH: The anterior midline approach to the craniocervical junction in children. Pematr Neurosurg 18:272–281, 1992.
Rights and permissions
Copyright information
© 2003 Springer Science+Business Media New York
About this chapter
Cite this chapter
Bhangoo, R.S., Crockard, H.A. (2003). Ventral Approaches to the Clivus, C1, and C2. In: Surgical Approaches to the Spine. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-0009-0_4
Download citation
DOI: https://doi.org/10.1007/978-1-4613-0009-0_4
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4612-6508-5
Online ISBN: 978-1-4613-0009-0
eBook Packages: Springer Book Archive