The Far-Lateral Approach and Its Variants: Technical Nuances and Video Illustration

Abstract

Far-lateral craniotomy is a versatile skull base approach that combines a suboccipital craniotomy with a C1 hemilaminectomy. The approach was initially described to manage vascular pathologies of the vertebrobasilar junction; however, the corridor provided by this approach can be applied to various pathologies in the ventral and ventrolateral craniovertebral region. Safe and successful execution of the approach requires an extensive understanding of the anatomy and technique. In this article, we discuss the advantages and disadvantages of the approach, as well as important technical nuances and common pitfalls. The goal of this article is to provide an up-to-date technical report of this approach supplemented by original high-quality dissections and a 4K 2-dimensional video as an educational resource for trainees and junior neurosurgeons.