Department of Neurosurgery, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Neurosurgery. 2010 Mar;66(3 Suppl):135-40. doi: 10.1227/01.NEU.0000365828.03949.D0.
The indications and operative technique for a number of posterolateral approaches to the craniovertebral junction (CVJ) are reviewed.
The literature addressing posterolateral approaches to the CVJ is reviewed, and illustrative cases are presented.
The far lateral approach and its variants, including the transcondylar, supracondylar, and paracondylar approaches, are an effective means of addressing intradural anterior and anterolateral CVJ lesions. These approaches provide exposure of the lower third of the clivus, the foramen magnum, and the upper cervical spine; do not cross contaminated regions; and enable a watertight dural closure to be performed. They are associated with minimal morbidity and usually do not significantly decrease the stability of the CVJ.
All surgeons treating lesions of the CVJ should be familiar with the posterolateral approach and its modifications.
回顾颅颈交界区（CVJ）多种后路入路的适应证和手术技术。
回顾了有关 CVJ 后路入路的文献，并介绍了一些典型病例。
远外侧入路及其各种改良入路，包括经髁、髁上和髁旁入路，是治疗颅颈交界区硬膜内前侧和前外侧病变的有效方法。这些入路可以显露斜坡下段、颅颈交界区和上颈椎；不穿过污染区域；可以进行严密的硬脑膜关闭。这些入路具有较小的发病率，通常不会显著降低 CVJ 的稳定性。
所有治疗 CVJ 病变的外科医生都应该熟悉后路入路及其改良方法。
