Surgical Approaches to the Craniocervical Junction for Neoplastic Lesions

Tumors of the craniocervical junction (CCJ) typically present diagnostic and technical challenges. The diagnosis is frequently delayed due to subtle early symptoms that are difficult to localize [9, 26]. Once diagnosed, these lesions pose surgical challenges due to the proximity and often the involvement of critical neurovascular structures. Tumor dimensions and structural involvement must be thoroughly assessed prior to surgery so that an appropriate approach is selected. The three surgical corridors to the CCJ are the anterior, posterior far lateral, and posterior midline approaches. Each approach has advantages and important limitations.