Department of Neurosurgery, The Johns Hopkins University School of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
Neurosurgery. 2010 Mar;66(3 Suppl):119-25. doi: 10.1227/01.NEU.0000365748.00721.0B.
A number of anterior approaches to the craniocervical junction have been described to allow exposure to the midline and lateral aspects of both the cranial base and upper cervical spine. The transoral-transpharyngeal approach, a technique that is well known to many spine surgeons, provides surgical access to the anterior clivus, C1, and C2. Transoral approaches provide the fundamental anatomy and technique upon which the more complex jaw-splitting approaches are based. This article discusses fundamental concepts regarding anatomy, perioperative considerations, and technical aspects critical to this important approach to the craniocervical junction. The transoral-transpharyngeal approach remains the "gold standard" for anterior approaches to the cervical spine. Endoscopic endonasal and endoscopic transcervical approaches are promising alternatives that may become more mainstream as experience with these approaches increases.
已经描述了许多颅颈交界区的前路入路，以允许暴露颅底中线和颅颈交界区的侧方，以及上颈椎。经口-经咽入路是一种许多脊柱外科医生都熟知的技术，它提供了对前斜坡、C1 和 C2 的手术入路。经口入路为更复杂的劈开下颌骨入路提供了基本的解剖学和技术基础。本文讨论了与该颅颈交界区重要入路相关的基本解剖学概念、围手术期注意事项和技术要点。经口-经咽入路仍然是颈椎前路入路的“金标准”。随着这些入路经验的增加，经鼻内镜和经颈椎内镜入路是很有前途的替代方法，可能会变得更加主流。
