Microsurgical treatment of tumors in the craniocervical junction via posterior median approach
DING Yiming
SHI Liang
YAN Tao
ZHU Jin
SU Yibing
Abstract：Objective To investigate the challenges and clinical efficacy of the posterior median approach for microsurgical resection of craniovertebral junction(CVJ)tumors.Methods Clinical data were collected from 35 CVJ tumor patients treated in the Department of Neurosurgery of Beijing Jishuitan Hospital affiliated to Capital Medical University between January 2021 and May 2024.According to the tumor location within the CVJ,different techniques were employed:midline incision for dorsal spinal cord tumors;enlarged laminectomy for ventral spinal cord tumors;and separation for dumbbell-shaped tumors in the intervertebral foramen region.Intraoperative monitoring of somatosensory evoked potentials(SEP)and motor evoked potentials(MEP)was performed throughout surgery,with an alarm threshold set at a>50%decrease in amplitude or>10%prolongation of latency to ensure neurological safety.Results Gross total resection was achieved in all patients with no residual tumor.The operative time ranged from 2 to 7 hours,with a mean of(3.90±1.29)hours.The patients showed significant symptomatic improvement after surgery,and no major complications occurred.During the follow-up period(6-36 months),no tumor recurrence was observed in any patient.Conclusions Microsurgical resection of CVJ tumors via the posterior median approach is a safe,effective,and widely applicable technique.It effectively preserves neurological function and maintains cervical stability.Intraoperative neurophysiological monitoring is a crucial adjunct for ensuring surgical safety.
Keywords：Craniovertebral junctionPosterior midline approachSpinal dumbbell tumorsCervical spine stability
Publication Date：2025-08-20
Online Publishing Date：2025-09-15(First online date of this platform, not the publication date of the document)
Pages：5( 342-345,354 )