The transoral approach to the superior cervical spine. A review of 53 cases of extradural cervicomedullary compression

• Published in: Journal of neurosurgery Vol. 71; no. 1; p. 16
• Main Authors: Hadley, M N, Spetzler, R F, Sonntag, V K
• Format: Journal Article
• Language: English
• Published: United States 01-07-1989
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Cerebrospinal Fluid - metabolism; Child; Child, Preschool; Female; Humans; Male; Medulla Oblongata - surgery; Middle Aged; Mouth - surgery; Neck; Nervous System - physiopathology; Postoperative Complications; Postoperative Period; Spinal Cord - surgery; Spinal Cord Compression - physiopathology; Spinal Cord Compression - surgery; Surgical Wound Dehiscence; Surgical Wound Infection
• ISSN: 0022-3085
• DOI: 10.3171/jns.1989.71.1.0016

The transoral-transclival surgical approach is the most direct operative approach to pathology ventral to the brain stem and superior spinal cord. In selected patients, this approach is efficacious in the treatment of extradural compressive lesions from the cervicomedullary junction to the C-4 vertebra. The authors have used the transoral surgical approach in treating 53 patients with lesions compressing the ventral extradural brain stem or the cervical cord. The evaluation, management, and long-term outcome of these patients are described (median follow-up time 24 months). The operative morbidity rate in this series was 6%, and the operative mortality rate was zero. The authors review specific features of the transoral procedure, including methods of retraction, microsurgical techniques, and adjunctive measures to avoid cerebrospinal fluid fistulae, that contributed to these good results.