Anterolateral approach to benign lesions of the cranio-spinal junction

The lateral approach to lesions of the cranio-cervical junction can be either postero-lateral or antero-luteral. These two routes have a specific indication according to the localization and extension of the tumor. In general, the majority of intradural lesions are treated using a postero-lateral approach whereas those with a predominantly extradural or extravertebral component more often require an antero-lateral approach. Consequently, the antero-lateral approach is used less frequently due to the relative rarity of extradural tumoral lesions of the cranio-spinal junction. As a matter of fact, the borderline between these 2 approaches is extremely narrow and a slightly more extensive mobilization of the neck muscles makes it possible to combine the two. For some benign or malignant tumoral pathologies of this region, the antero-lateral approach should be preferred (dumb-bell neurinomas, infiltrating meningiomas, chordomas, métastases). The authors describe their experience with several benign cranio-spinal tumors and describe the highlights of the technique.