title: Direct lateral approach to pathology at the craniocervical junction:  a technical note.
abstract: BACKGROUND
  Approaches to the foramen magnum and upper cervical spine traditionally include the posterior midline, far lateral, and endoscopic endonasal approaches. The far lateral approach is a well-established technique for the removal of pathology ventrolateral to the brainstem and the craniocervical junction, but it may be too extensive for lesions limited to areas far from the midline.
  
  
  OBJECTIVE
  To present an alternative to the commonly used approaches to the foramen magnum and upper cervical.
  
  
  METHODS
  We used an approach directly overlying ventral or lateral pathology.
  
  
  RESULTS
  Two cases are presented in which the direct lateral approach followed by an occipitocervical fusion was successfully performed.
  
  
  CONCLUSIONS
  This approach can be considered for patients in whom a ventral decompression is necessary but an endoscopic endonasal approach is undesirable or when a ventral, lateral, and ventrolateral resection of tumor, pannus, or infection is required.
authors.affiliation: Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA.
authors.forename: Kalil G
authors.initials: KG
authors.lastname: Abdullah
authors.forename: Richard S
authors.initials: RS
authors.lastname: Schlenk
authors.forename: Ajit
authors.initials: A
authors.lastname: Krishnaney
authors.forename: Michael P
authors.initials: MP
authors.lastname: Steinmetz
authors.forename: Edward C
authors.initials: EC
authors.lastname: Benzel
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Mroz
mesh_terms: D000368:Aged; D001268:Atlanto-Axial Joint / Q000473:pathology / Q000601:surgery*; D001269:Atlanto-Occipital Joint / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005539:Foramen Magnum / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D011859:Radiography; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*