A modified “far-lateral” approach for safe resection of retroodontoid dural cysts

Abstract

Cystic mass lesions at the ventral craniocervical junction have been described only rarely in the past, however, they have received more attention with improved imaging modalities in recent years. These lesions have been approached by various operative procedures. A modified ''far-lateral'' approach combined with a C1 hemilaminectomy without fusion was used to safely remove the cyst and decompress the cervical medulla in a 72-year-old woman with cervicooccipital pain and paresthesia in both arms. Following surgery, complete resolution of symptoms was achieved, and no recurrence at 1 year follow-up was detected. A modified ''far-lateral'' approach offers several advantages when compared with other operation techniques.

A Minimal Access Far-Lateral Approach to Foramen Magnum Lesions

“…Bertalanffy et al 13 utilized a long paramedian incision and muscle-splitting approach in one of the first reports describing a far-lateral transcondylar modification to suboccipital craniotomy. More recently, Lutjens et al 14 reported a modified far-lateral approach using a paramedian muscle-splitting approach for resection of a retro-odontoid dural cyst. Here we present an anatomical and clinical study that demonstrates the feasibility of the minimal access far-lateral approach in treating a variety of foramen magnum lesions.…”