Far lateral approach(FLA),together with its modified approaches,is a fundamental surgical approach for surgical resection of lesions located at the ventral or ventrolateral side of the foramen magnum.[1,2,3,4,5]The ke...Far lateral approach(FLA),together with its modified approaches,is a fundamental surgical approach for surgical resection of lesions located at the ventral or ventrolateral side of the foramen magnum.[1,2,3,4,5]The key procedure in FLA is exposing the vertebral artery(VA)especially the V3 segment.[1,5,6]When performing an FLA,most neurosurgeons choose to expose the suboccipital triangle(formed by the rectus capitis posterior major,the superior oblique,and the inferior oblique)as a key anatomical landmark initially and then expose the V3 segment.[1,2,5,6,7]However,on the one hand,this muscular anatomical landmarks-suboccipital triangle varies in depth,morphology,and location in different patients,which increases the risk of VA injury during surgery.[3]On the other hand,this procedure could lead to exposing difficulty due to the obstruction of overlying layers of muscles and the distribution of blood vessels,which could prolong the time for craniotomy fairly.The course of VA could vary,such as looping backward and bulge posteriorly between the lips of the suboccipital triangle,where it could be damaged if one expects it to be found in the depth of the suboccipital triangle.[3]Thus,neurosurgeons have the potential for VA injury and a rather prolonged time to successfully expose VA.展开更多
基金This work is financially supported by the grants from the Program of Science and Technology Department of Sichuan Province(No.2021YFS0205 and No.2020YFS0222)the Program of Health Commission of Sichuan Province(No.20PJ051)。
文摘Far lateral approach(FLA),together with its modified approaches,is a fundamental surgical approach for surgical resection of lesions located at the ventral or ventrolateral side of the foramen magnum.[1,2,3,4,5]The key procedure in FLA is exposing the vertebral artery(VA)especially the V3 segment.[1,5,6]When performing an FLA,most neurosurgeons choose to expose the suboccipital triangle(formed by the rectus capitis posterior major,the superior oblique,and the inferior oblique)as a key anatomical landmark initially and then expose the V3 segment.[1,2,5,6,7]However,on the one hand,this muscular anatomical landmarks-suboccipital triangle varies in depth,morphology,and location in different patients,which increases the risk of VA injury during surgery.[3]On the other hand,this procedure could lead to exposing difficulty due to the obstruction of overlying layers of muscles and the distribution of blood vessels,which could prolong the time for craniotomy fairly.The course of VA could vary,such as looping backward and bulge posteriorly between the lips of the suboccipital triangle,where it could be damaged if one expects it to be found in the depth of the suboccipital triangle.[3]Thus,neurosurgeons have the potential for VA injury and a rather prolonged time to successfully expose VA.
