How I do it: dorsolateral approach for ventrolateral intramedullary cavernoma

Background For small and lateral lesions, in order to avoid postoperative sequelae related to dorso-median myelotomy, we propose to describe the use of a ventrolateral approach for intramedullary lesions. Method Performing this approach entails that the denticulate ligament is cut from its dural att...

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Bibliographic Details
Published in:Acta neurochirurgica 2020-05, Vol.162 (5), p.1127-1129
Main Authors: Dauleac, Corentin, Pelissou-Guyotat, Isabelle
Format: Article
Language:English
Subjects:
Complications
How I Do it - : Vascular Neurosurgery - Other
Interventional Radiology
Lesions
Medicine
Medicine & Public Health
Minimally Invasive Surgery
Neurology
Neuroradiology
Neurosurgery
Spinal cord
Surgical Orthopedics
Vascular Neurosurgery – Other
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Summary:Background For small and lateral lesions, in order to avoid postoperative sequelae related to dorso-median myelotomy, we propose to describe the use of a ventrolateral approach for intramedullary lesions. Method Performing this approach entails that the denticulate ligament is cut from its dural attachment and retracted. Rotation of the spinal cord must be achieved with great caution and under electrophysiological monitoring. After pia mater incision, hydrodissection is useful to gently dissect the cavernoma and promote a cleavage plane. Conclusion In the case of lateral intramedullary lesions, using this approach maximized the absence of postoperative deficit.
ISSN:0001-6268
0942-0940
DOI:10.1007/s00701-019-04188-6