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The surgical anatomy of six variations of the extreme lateral approach
(Turkish Neurosurgical Society, 1999) Ziyal, İbrahim Mustafa; Salas, Eduardo; Sekhar, Laligam N.
The extreme lateral transcondylar approach (ELA) is used to access lesions that are located or extend superior to the middle clivus, inferior to the upper cervical spine, and lateral to the foramina jugulare. Different combinations of drilling of several bone structures, including the occipital condyle, the C1 and C2 facets and laminae, and the jugular tubercle and process, coupled with suboccipital craniotomy, equip the surgeon with different ways of approaching the region of interest. In order to fully understand the options for ELA, it is useful to clarify the variations of this approach. This study involved the bilateral use of 10 complete cadaveric head specimens and includes the description and discussion of six different variations of ELA relative to lesion location and the need for subsequent occipito-cervical fusion. The ELA options are as follows: 1. Retrocondylar approach (RCA) 2. Partial transcondylar approach (PTCA) 3. Transtubercular approach (TTA) 4. Transcondylar approach (TCA) 5. Transjugular approach (TJA) 6. Transfacetal approach (TFA).