Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan;165(1):165-168.
doi: 10.1007/s00701-022-05424-2. Epub 2022 Nov 22.

Posterolateral transpedicular approach for ventrally seated cervicothoracic spinal cord lesions: how I do it

P M F Cristaldi  1   2 , A Parlangeli  3 , D Nicoli  3 , M Incerti  3
Affiliations

Posterolateral transpedicular approach for ventrally seated cervicothoracic spinal cord lesions: how I do it

P M F Cristaldi et al. Acta Neurochir (Wien). 2023 Jan.

Abstract

Background: Surgical exposure of lower cervical and upper thoracic intradural extramedullary lesions located along the ventral medulla are among the most complexes to address in spinal surgery, and their surgical removal carries a high risk.

Methods: We describe the surgical steps of a posterolateral transpedicular approach for resection of an intradural extramedullary lesion located anterolaterally at C7-T1 level.

Conclusions: A posterolateral transpedicular approach is a safe and efficient surgical corridor to explore the ventral spinal cord and to have a direct access to lower cervical-upper thoracic lesions without the extensive manipulation of the spinal cord and the spine instability.

Keywords: Cervicothoracic region; Spinal cord tumor; Surgical approach; Transpedicular approach; Ventral spinal lesion.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
MRI (a sagittal sequence on STIR; b axial sequence on T2) showed intradural extramedullary lesion located ventrally and on the left side with severe spinal cord compression at the level of C7-T1
Fig. 2
Fig. 2
A sagittal MRI T2 sequence (a) and a lateral (b) and anteroposterior (c) cervical radiography performed at 3 and 6 months after surgery, respectively, showed a preservation of the spinal alignment
See this image and copyright information in PMC

References

    1. Eroglu U, Bahadır B, Tomlinson SB, Ugur HC, Sayaci EY, Attar A, Caglar YS, Cohen Gadol AA. Microsurgical management of ventral intradural-extramedullary cervical meningiomas: technical considerations and outcomes. World Neurosurg. 2020;135:e748–e753. doi: 10.1016/j.wneu.2019.12.145. - DOI - PubMed
    1. Ghasem A, Gjolaj JP, Greif DN, Green BA. Excision of a centrally based ventral intradural extramedullary tumor of the cervical spine through a direct posterior approach. Spinal Cord Ser Cases. 2017;15(3):17092. doi: 10.1038/s41394-017-0017-8. - DOI - PMC - PubMed
    1. Ito K, Aoyama T, Miyaoka Y, Seguchi T, Horiuchi T, Hongo K. Surgery for ventral intradural thoracic spinal tumors with a posterolateral transpedicular approach. Acta Neurochir (Wien) 2016;158(8):1563–1569. doi: 10.1007/s00701-016-2864-7. - DOI - PubMed
    1. Kim CH, Chung CK. Surgical outcome of a posterior approach for large ventral intradural extramedullary spinal cord tumors. Spine (Phila Pa 1976) 2011;36(8):E531–7. doi: 10.1097/BRS.0b013e3181dc8426. - DOI - PubMed
    1. Zhang J, Tsuzuki N, Hirabayashi S, Saiki K, Fujita K. Surgical anatomy of the nerves and muscles in the posterior cervical spine: a guide for avoiding inadvertent nerve injuries during the posterior approach. Spine (Phila Pa 1976) 2003;28(13):1379–84. doi: 10.1097/01.BRS.0000067095.75764.D3. - DOI - PubMed

Publication types