Komotar Ricardo J, Zacharia Brad E, McGovern Robert A, Sisti Michael B, Bruce Jeffrey N, D'Ambrosio Anthony L
Department of Neurological Surgery, Columbia University, New York.
J Craniovertebr Junction Spine. 2010 Jul;1(2):86-99. doi: 10.4103/0974-8237.77672.
Foramen magnum (FM) lesions represent some of the most complex cases for the modern neurosurgeon because of their location near vital brainstem structures, the vertebral arteries, and lower cranial nerves. In particular, anterior or anterolaterally located FM tumors have traditionally been most difficult to resect with high morbidity and mortality resulting from approaches through the posterior midline or transorally. For many neurosurgeons, the far lateral, extreme lateral approach, and more recently, endoscopic endonasal approaches have become the preferred modern methods for the resection of anterior or anterolateral FM tumors. In this review, we examine both operative and non-operative approaches to FM tumors, including surgical anatomy, surgical technique, and indications for operative intervention in these complex cases. In addition, we compared outcomes from prior series.
枕骨大孔（FM）病变对现代神经外科医生来说是一些最复杂的病例，因为它们位于重要的脑干结构、椎动脉和低位颅神经附近。特别是，传统上，位于前方或前外侧的FM肿瘤通过后正中或经口入路切除最为困难，会导致较高的发病率和死亡率。对许多神经外科医生来说，远外侧、极外侧入路，以及最近的内镜鼻内入路已成为切除前方或前外侧FM肿瘤的首选现代方法。在本综述中，我们研究了FM肿瘤的手术和非手术方法，包括手术解剖、手术技术以及这些复杂病例的手术干预指征。此外，我们比较了先前系列研究的结果。
