Abstract：
The foramen magnum approach is always challenging because of the relationships between vital neurovascular structures in this area. Several approaches have been described, among them, the far lateral approach remains a cornerstone for the resection of anterior or anterolateral processes of the foramen magnum. This approach displays two main steps: the first is cervical, whereas the second is cranial.We report the case of a 63 year-old woman admitted for a progressive quadriplegia with swallowing disorders revealing a process of the anterior and anterolateral part of the foramen magnum. A cervical step of a far lateral approach without opening the foramen magnum achieved a near total resection of the process via a trans-tumor corridor and confirmed a dumbbell shape neurofibroma. The postoperative period showed a resolution of swallowing disorders and a progressive improvement of muscular strength. At 8 months follow-up, she was asymptomatic and able to walk with a normal balance. The surgical technique and anatomical correlation of this trans-tumor approach are discussed.
摘要：
由于该区域重要的神经血管结构之间的关系，大孔入路总是具有挑战性。已经描述了几种方法，其中,远外侧入路仍然是切除大孔前或前外侧的基石。这种方法显示了两个主要步骤：第一个是宫颈，而第二个是颅骨。我们报告了一名63岁的女性因进行性四肢瘫痪而吞咽障碍而入院的病例，该病例揭示了大孔的前外侧和前外侧的过程。不打开大孔的远外侧入路的子宫颈台阶通过跨肿瘤走廊几乎完全切除了该过程，并证实了哑铃形神经纤维瘤。术后期间显示吞咽障碍的解决和肌肉力量的逐渐改善。在8个月的随访中，她无症状，能够正常行走。讨论了这种跨肿瘤入路的手术技术和解剖学相关性。
