TY - JOUR
T1 - Morphometric and radiomorphometric study of the correlation between the Foramen Magnum Region and the anterior and posterolateral approaches to ventral intradural lesions
AU - Luzzi, Sabino
AU - Del Maestro, Mattia
AU - Elia, Angela
AU - Vincitorio, Francesca
AU - Perna, Giuseppe Di
AU - Zenga, Francesco
AU - Garbossa, Diego
AU - Elbabaa, Samer K.
AU - Galzio, Renato
PY - 2019/1/1
Y1 - 2019/1/1
N2 - AIM: To identify the range of dimensional morphometric variability correlated to the basilar and condylar part of the occipital bone, which may affect the choice of approach to ventral intradural foramen magnum (FM) lesions. MATERIAL and METHODS: In total, 25 dry skulls and 50 head computed tomography (CT) scan results have been assessed in detail, focusing on the FM, occipital condyles, jugular tubercles (JT), and hypoglossal canals (HC). A morphometric analysis has been carried out using linear and angular measurements to estimate the range of the dimensional variability of these structures. Data were presented as mean ± standard deviation, ranges, and interquartile range on a boxplot. The sagittal intercondylar angle (SICA) and anterior condylar angle (ACA) have been found to be important in estimating the axial orientation of the condyles, whereas the JT-HC interline ratio has indicated the prominence of the tubercles. RESULTS: The SICA and ACA have exhibited high variability. The average JT-HC interline ratio was 0.8. Wider SICA-ACA and higher JT-HC interline ratio make the posterolateral approach advantageous. An anterior medial or far-medial endoscopic route is indicated in opposite conditions. In this study, two illustrative cases have been reported. CONCLUSION: A cautious preoperative morphometric evaluation of the FM region must be considered prior to using tailored and safe anterior endoscopic and posterolateral approaches to ventral intradural lesions to identify the advantages of a certain corridor as much as possible, thereby minimizing the risk of complications.
AB - AIM: To identify the range of dimensional morphometric variability correlated to the basilar and condylar part of the occipital bone, which may affect the choice of approach to ventral intradural foramen magnum (FM) lesions. MATERIAL and METHODS: In total, 25 dry skulls and 50 head computed tomography (CT) scan results have been assessed in detail, focusing on the FM, occipital condyles, jugular tubercles (JT), and hypoglossal canals (HC). A morphometric analysis has been carried out using linear and angular measurements to estimate the range of the dimensional variability of these structures. Data were presented as mean ± standard deviation, ranges, and interquartile range on a boxplot. The sagittal intercondylar angle (SICA) and anterior condylar angle (ACA) have been found to be important in estimating the axial orientation of the condyles, whereas the JT-HC interline ratio has indicated the prominence of the tubercles. RESULTS: The SICA and ACA have exhibited high variability. The average JT-HC interline ratio was 0.8. Wider SICA-ACA and higher JT-HC interline ratio make the posterolateral approach advantageous. An anterior medial or far-medial endoscopic route is indicated in opposite conditions. In this study, two illustrative cases have been reported. CONCLUSION: A cautious preoperative morphometric evaluation of the FM region must be considered prior to using tailored and safe anterior endoscopic and posterolateral approaches to ventral intradural lesions to identify the advantages of a certain corridor as much as possible, thereby minimizing the risk of complications.
KW - Far-lateral approach
KW - Foramen magnum
KW - Jugular tubercle
KW - Occipital condyles
KW - Transclival approach
UR - http://www.scopus.com/inward/record.url?scp=85070876260&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85070876260&partnerID=8YFLogxK
U2 - 10.5137/1019-5149.JTN.26052-19.2
DO - 10.5137/1019-5149.JTN.26052-19.2
M3 - Article
C2 - 31452176
AN - SCOPUS:85070876260
VL - 29
SP - 875
EP - 886
JO - Turkish Neurosurgery
JF - Turkish Neurosurgery
SN - 1019-5149
IS - 6
ER -