Alshafai Nabeel S, Klepinowski Tomasz
Alshafai Neurosurgical Academy (ANA), Toronto, ON, Canada.
Department of Neurosurgery, Collegium Medicum Jagiellonian University, Alshafai Neurosurgical Academy (ANA), Kraków, Poland.
Acta Neurochir Suppl. 2019;125:159-164. doi: 10.1007/978-3-319-62515-7_23.
Since 1972, when Hammon first described the far lateral approach (FLA) for treatment of vertebral artery aneurysms, it has undergone numerous modifications, including drilling of the occipital condyle, removal of the laminas of upper cervical vertebrae and so on. Also, the range of indications has increased exponentially.
In this paper we discuss state-of-the-art advances in the FLA, such as promising minimally invasive variants where an endoscope is used, and many others.
We reviewed all articles touching upon the FLA in the modern era (from the year 2000 onward) and selected those that presented a significant contribution to the development of the relevant approach. The database used was PubMed.
We found several new caveats not mentioned in other reviews or book chapters. The FLA is an ever-changing field of battle where the common and ultimate goals are to minimize the risk of injuring the major vessel in the region-the vertebral artery-and to provide such an angle of attack upon the tumours in the anterior and anterolateral foramen magnum that it is feasible to ensure gross total resection. This paper is an update on the knowledge about this approach, which we feel is necessary.
自1972年哈蒙首次描述用于治疗椎动脉动脉瘤的远外侧入路（FLA）以来，该入路经历了多次改良，包括枕髁钻孔、上颈椎椎板切除等。此外，其适应证范围也呈指数级增长。
在本文中，我们讨论远外侧入路的最新进展，例如使用内窥镜的有前景的微创变体等诸多进展。
我们回顾了现代（从2000年起）所有涉及远外侧入路的文章，并选择了那些对相关入路发展有重大贡献的文章。所使用的数据库为PubMed。
我们发现了一些其他综述或书籍章节中未提及的新注意事项。远外侧入路是一个不断变化的领域，其共同的最终目标是将损伤该区域主要血管——椎动脉的风险降至最低，并提供一个能从前部和前外侧枕骨大孔对肿瘤进行攻击的角度，以便确保能够实现肿瘤全切。本文是对该入路相关知识的更新，我们认为这是必要的。
