gms | German Medical Science

59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

01. - 04.06.2008, Würzburg

A modified “far-lateral” approach for safe resection of retroodontoid dural cysts

Ein modifizierter “far-lateral” approach zur sicheren operativen Entfernung retroodontoid gelegener duraler Zysten

Meeting Abstract

Suche in Medline nach

  • corresponding author G. Lütjens - Medizinische Hochschule Hannover, Klinik für Neurochirurgie, Hannover
  • C. Bärlocher - Klinik Stephanshorn, Klinik für Neurochirurgie, St. Gallen
  • J. K. Krauss - Medizinische Hochschule Hannover, Klinik für Neurochirurgie, Hannover

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocP 084

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2008/08dgnc352.shtml

Veröffentlicht: 30. Mai 2008

© 2008 Lütjens et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Cystic mass lesions of the ventral craniocervical junction are rare lesions that may cause cervical myelopathy. There is controversy on their optimal treatment and a variety of different surgical approaches were used in the past. We introduce a modified “far-lateral” approach for save treatment and to prevent postoperative instability.

Methods: The modified “far-lateral” approach consists of a C1 hemilaminectomy combined with drilling of the most medial aspect of the right condyle to approach the ventral extraaxial cystic lesion.

Results: The modified “far-lateral” approach was used in a 74-year-old woman complaining about dizziness, cervico-occipital pain and paresthesias in both arms. The neurological examination revealed slight loss of strength of the right side. MR imaging showed an 8x9x8 mm extraaxial cystic lesion at C0/C1 ventral to the spinal cord. The lesion was approached without any compromise of the upper spinal cord and other neural and vascular structures and was resected at ease. The postoperative course was uneventful. One year postoperatively, MR imaging was unremarkable. The neurological examination was normal. There was no instability.

Conclusions: The modified “far-lateral” approach for treatment of retroodontoid cysts offers several advantages compared to other options. It is less invasive than the transoral approach, while it does not result in postoperative instability which is the case in more extensive dorsolateral approaches. It offers optimal control of neurovascular structures. With regard to the aging population in Western countries retroodontoid cysts should be expected to be more frequent in the future and they should be included in the differential diagnosis of the upper cervical myelopathy. They can be removed safely by a limited approach.