CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2019; 80(S 04): S375-S377
DOI: 10.1055/s-0039-1698820
Skull Base: Operative Videos
Georg Thieme Verlag KG Stuttgart · New York

Anterolateral Approach with Endoscopic Assistance for Resection of a Craniovertebral Junction Chordoma

Pierre-Olivier Champagne
1  Department of Neurosurgery, Lariboisiere Hospital, University of Paris Diderot, Paris, France
,
Eduard H. Voormolen
1  Department of Neurosurgery, Lariboisiere Hospital, University of Paris Diderot, Paris, France
,
Sébastien Froelich
1  Department of Neurosurgery, Lariboisiere Hospital, University of Paris Diderot, Paris, France
› Author Affiliations
Further Information

Publication History

28 February 2019

25 August 2019

Publication Date:
28 October 2019 (online)

  

Abstract

Craniovertebral junction chordomas can represent a surgical challenge, especially when intradural extension and contact with neurovascular structures is involved. To date, there is still controversy on the choice of optimal surgical corridor for such lesions, with endoscopic endonasal, far lateral and anterolateral corridors being those most commonly used. In this operative video, we present a case of craniovertebral junction chordoma with significant bone destruction and intradural extension ([Fig. 1]). The tumor was safely removed using an anterolateral approach with transposition of the vertebral artery to gain access to the lateral craniovertebral junction. The endoscope is demonstrated to help with intradural tumor removal, providing a wide angle of view through a relatively narrow dural opening ([Fig. 2]). In this video, nuances of the anterolateral approach, chordoma removal strategies and closure technique are presented in detail. A gross total resection was achieved, and the postoperative course was uneventful. In summary, the anterolateral approach with endoscopic assistance can offer a safe and effective corridor for the surgical management of craniovertebral junction chordomas.

The link to the video can be found at: https://youtu.be/pC0YxKgNoMY.