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Neurosurgical Review

, Volume 37, Issue 1, pp 115–126 | Cite as

Posterior condylar canals and posterior condylar emissary veins—a microsurgical and CT anatomical study

  • Ken Matsushima
  • Masatou Kawashima
  • Toshio Matsushima
  • Tetsuya Hiraishi
  • Tomoyuki Noguchi
  • Akio Kuraoka
Original Article

Abstract

The posterior condylar canals (PCCs) and posterior condylar emissary veins (PCEVs) are potential anatomical landmarks for surgical approaches through the lateral foramen magnum. We conducted computed tomography (CT) and microsurgical investigation of how PCCs and PCEVs can aid in planning and performing these approaches. We analyzed the microanatomy of PCCs and PCEVs using cadaveric specimens, dry skulls, and CT images. The recognition frequency and geometry of PCCs and PCEVs and their relationships with surrounding structures were evaluated. PCCs were identified in 36 of 50 sides in dry bones and 82 of 100 sides by CT. PCCs had a 3.5-mm mean diameter and a 6.8-mm mean canal length. We classified their courses into four types according to intracranial openings: the sigmoid sinus (SS) type, the jugular bulb (JB) type, the occipital sinus type, and the anterior condylar emissary vein type. In most cases, PCEV originated near the boundary between the SS and JB. PCCs and PCEVs can be useful anatomical landmarks to differentiate the transcondylar fossa approach from the transcondylar approach, thus preventing unnecessary injury of the atlantooccipital joint. They can also be used as landmarks when the jugular foramen (JF) and hypoglossal canal (HGC) are being exposed. The area anterior to the brain stem and the medial part of HGC can be accessed by removal of the lateral foramen magnum medial to PCC. JF and the lateral part of HGC can be accessed by removal of the skull base lateral to PCC without damaging the lateral rim of the foramen magnum.

Keywords

Posterior condylar canal Posterior condylar emissary vein Lateral foramen magnum Microsurgical anatomy Surgical approaches Craniocervical junction 

Notes

Acknowledgments

We would like to express our gratitude to Emeritus Professor Albert L. Rhoton Jr, Dr. Toshiro Katsuta, and Dr. Hiroshi Muratani for their valuable advice and comments. We also thank Mr. Shigetoshi Kitamura, Mrs. Yumiko Oishi, and Mrs. Sumiko Matsushima for their assistance in preparing and completing this manuscript.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Ken Matsushima
    • 1
    • 2
  • Masatou Kawashima
    • 1
  • Toshio Matsushima
    • 1
  • Tetsuya Hiraishi
    • 3
  • Tomoyuki Noguchi
    • 4
  • Akio Kuraoka
    • 5
  1. 1.Department of Neurosurgery, Faculty of MedicineSaga UniversitySagaJapan
  2. 2.Center for Graduate Medical Education Development and ResearchSaga University HospitalSagaJapan
  3. 3.Department of Neurosurgery, Brain Research InstituteUniversity of NiigataNiigataJapan
  4. 4.Department of Radiology, Faculty of MedicineSaga UniversitySagaJapan
  5. 5.Department of Anatomy and Biological Anthropology, Faculty of MedicineSaga UniversitySagaJapan

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