ANTEROLATERAL AND POSTEROLATERAL APPROACHES TO THE FORAMEN-MAGNUM - TECHNICAL DESCRIPTION AND EXPERIENCE FROM 97 CASES

Over a 12-year period (1981-1993), 97 lesions located in the foramen m agnum area were treated using either the posterolateral or the anterol ateral approach. The former is a lateral extent of the midline posteri or approach; the latter is the technique of exposure of the cervical v ertebral artery applied at the C-1 to C-2 level. The choice between th e two types of lateral approaches was made following three modes of lo calization: anteroposterior attachment, relation to the dura, and rela tion to the vertebral artery. Both techniques are described in detail, with special attention paid to the bone and dural openings, which var y according to the localization. The treated lesions include 98 tumors , 4 craniocervical junction malformations, 1 synovial cyst, and 1 abce ss. A complete resection was realized in 95% of the tumoral cases, wit h a very limited morbidity and mortality (3%).