頭蓋頚椎移行部・上位頚椎腹側の占拠性病変に対する手術方法

概要

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We report the results of surgical treatment of lesions in the cranio-vertebral junction and qualify the decision to use a surgical approach. 40 cases were treated. In consideration of the location of the lesion, relationship to lower cranial nerves and vertebral artery, some cases were added large suboccipital craniotomy, condylar resection and/or resection for transverse process of atlas and axis. We could remove the lesion totally in 88% of the cases. All of the cases had improvement in neurological symptoms. Subtotal removal was performed in three cases, because the tumor had adhesion to the brain stem or lower cranial nerves. For the lesions in the craniovertebral junction, the basic approach was dorsolateral approach, for the lesion extending to the spinal canal was performed hemilaminectomy of the atlas and axis. In consideration of the location of the lesion, the relationship to lower cranial nerves and the vertebral artery, suboccipital craniotomy, condylar resection and/or resection of transverse process of the atlas and axis should be added. For the intramedullary lesion, we should make the approach more laterally to get to the lesion directly.
日本脊髄外科学会の論文
2005-03-31