Department of Neurosurgery, Saga University, Saga, Japan.
Neurol India. 2012 Nov-Dec;60(6):638-42. doi: 10.4103/0028-3886.105201.
In chordoma, complete surgical removal of the epidural tumor should be the first choice of treatment. Numerous surgical approaches to clival chordoma have been described: anterior approaches, lateral approaches, and posterolateral approaches. A multistaged operation with a combination of these approaches is generally performed. We used three approaches to remove a clival chordoma extending from the lower clivus anteriorly to the anterior perivertebral space and inferiorly to the C2 level. The epidural posterolateral approach through the vertebral artery (VA)-C2 interval space after resection of the C2 dorsal ganglion was the most effective. To our knowledge, the epidural posterolateral approach below VA, referred to as C2 ganglion sectioning epidural approach has not been reported as an independent approach in detail. We report a two-year-old girl with a lower clival chordoma which has been excised using C2 ganglion sectioning epidural approach.
在脊索瘤中，完全切除硬膜外肿瘤应是首选治疗方法。已描述了许多颅底脊索瘤的手术入路：前路入路、外侧入路和后外侧入路。通常采用这些入路的多阶段手术。我们使用三种方法切除了一个从前下颅底延伸到前椎旁间隙、下至 C2 水平的颅底脊索瘤。切除 C2 背根神经节后通过椎动脉（VA）-C2 间隔空间进行的硬膜外后外侧入路是最有效的。据我们所知，在 VA 下方的硬膜外后外侧入路，称为 C2 神经节切断硬膜外入路，尚未作为一种独立的入路详细报道。我们报告了一例使用 C2 神经节切断硬膜外入路切除的 2 岁女孩的下颅底脊索瘤。
