Abstract
The vertebral artery (VA) is a vessel which most surgeons are reluctant to deal with. Very often the attitude during surgical exposure is to avoid to see it on the basis that staying at some distance will avoid problems. In fact the VA can be safely exposed and controlled on any of its segments. Moreover this exposure may be useful in many different pathologies either to permit a more radical removal if they are in close contact with the VA or to improve the access to them in some surgical approaches.
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References
Abd El-Bary TH, Dujovny M, Ausman JI (1995) Microsurgical anatomy of the atlantal part of the vertebral artery. Surg Neurol 44: 392–401
Al-Mefty O, Borba AB, Aoki N, Angtuaco E, Pait TG (1996) The transcondylar approach to extradural nonneoplastic lesions of the craniovertebral junction. J Neurosurg 84: 1–6
Arnautovic KI, Al-Mefty O, Pait G, Krisht AF, Husain MM (1997) The suboccipital cavernous sinus. J Neurosurg 86: 252–262
Bauer RB, Sheeha S, Meyer JS (1961) Arteriographic study of cerebral vascular disease. II: cerebral symptoms due to a kingking tortuosity and compression of carotid and vertebral arteries in the neck. Arch Neurol 4: 119 – 131
Berguer R, Andaya LV, Bauer RB (1976) Vertebral artery by-pass. Arch Surg 111:976–979
Berguer R, Feldman AJ (1983) Surgical reconstruction of the vertebral artery. Surgery 93: 670–675
Bertalanffy H, Seeger W (1991) The dorsolateral, suboccipital, transcondylar approach to the lower clivus and anterior portion of the craniocervical junction. Neurosurgery 29: 815–821
Bongioanni F, Assadurian E, Polivka M, George B (1996) Aneurysmal bone cyst of the atlas. Operative removal by an anterolateral approach. A case report. J Bone Joint Surg 78: 1574–1577
Budway RJ, Senter HJ (1993) Cervical disc rupture causing vertebrobasilar insufficiency. Neurosurgery 33: 745–747
Camp PE (1984) Carotid to distal vertebral artery bypass for vertebrobasilar ischemia. Case report. J Neurosurg 60: 187–189
Carney AL (1981) Vertebral artery surgery: historical development, basic concepts of brain hemodynamics, and clinical experience of 102 cases. Advances in neurology. Diagnosis and treatment of brain ischemia, vol 30. Raven Press, New York, pp 249–282
Citow JS, Macdonald RL (1999) Posterior decompression of the vertebral artery narrowed by cervical osteophyte: case report. Surg Neurol 51: 495–499
Clark K, Perry MU (1956) Carotid vertebral anastomosis: an alternative technir for repair of the subclavian steal syndrome. Ann Surg 1963: 414–416
Corkill G, French BH, Michas C, Cobb CA, Mims TJ (1977) External carotid vertebral artery anastomosis for vertebro-basilar insufficiency. Surg Neurol 7: 109–115
Courtheoux P, Tournade A, Theron J et al (1985) Transcutaneous angioplasty of vertebral artery atheromatous ostial structure. Neuroradiology 27: 259–264
Dekleyn A, Versteegh (1933) Über verschiedene Formen von Meniere’s Syndrom. Dtsch Z Nervenheilkde 132: 157–189
Diaz FG, Ausman JI, De Los Reyes RA, Pearce J, Shroutz C, Pak H, Turcott J (1984) Surgical reconstruction of the proximal vertebral artery. J Neurosurg 61: 874–881
Diaz FG, Ausman JI, Shroutz, Pearce J, Tiel R (1985) Surgical reconstruction of the second portion of the vertebral artery in cerebral revascularization for stroke. In: Spetzler RF (ed) Thieme-Stratton, New York, pp 325–329
Feldman AJ (1984) Surgical approach to disease of the first portion of the vertebral artery. Vertebro-basilar arterial occlusive disease. Medical and surgical management. Raven Press, New York, pp 231–239
Fontaine D, Lot G, George B (1999) Intramedullary cavernous angioma. Resection by oblique corpectomy. Surg Neurol 51: 435–441
Fox MW, Piepgras DG, Bartleson JD (1995) Anterolateral decompression of the atlantoaxial vertebral artery for symptomatic positional occlusion of the vertebral artery. Case report. J Neurosurg 83: 737–740
Francke JP, Dimarino V, Pannier M, Argenson Cl, Libersa Cl (1980) Les artères vertébrales. Segments atlanto-axoïdiens V3 et intra-crânien V4 collaterales. Anatomia Clinica 2: 229–242
Francke JP, Dimarino V, Pannier M, Argenson C, Libersa Cl (1981) The V3 atlanto-axoïdal and V4 intracranial segments collaterals. Anatomia Clinica 2: 229–242
George B, Laurian C (1980) Surgical approach to the whole length of the vertebral artery with special reference to the third portion. Acta Neurochir (Wien) 51: 259–272
George B, Laurian C (1982) Vertebro-basilar ischaemia. Its relation to stenosis and occlusion of the vertebral artery. Acta Neurochir (Wien) 62: 287–295
George B, Laurian C, Cophignon J, Rey A (1982) Traitement des tumeurs en rapport avec l’artère vertébrale dans sa portion transversaire. Neurochirurgie 28: 173–178
George B, Laurian C, Keravel Y, Cophignon J (1985) Extradural and hourglass cervical neurinomas: the vertebral artery problem. Neurosurgery 16: 591–594
George B, Laurian C (1986) Indication des revascularisations de l’artère vertébrale cervicale distale. Ann Med Interne 137: 108–111
George B, Laurian C (1987) The vertebral artery. Pathology and surgery. Springer, Berlin Heidelberg New York Tokyo pp 1–258
George B, Dematons C, Cophignon J (1988) Lateral approach to the anterior portion of the foramen magnum application to surgical removal of 14 benign tumors: technical note. Surg Neurol 29: 484–490
George B, Laurian T (1989) Impairment of vertebral artery flow caused by extrinsic lesions. Neurosurgery 24: 206–214
George B (1991) Meningiomas of the foramen magnum. In: Meningiomas and their surgical treatment, vol 42. In: Schmidek HH (ed) WB Saunders Company Philadelphia, pp 459–470
George B, Zerah M, Lot G, Hurth M (1993) Oblique transcorporeal approach to anteriorly located lesions in the cervical spine canal. Technical note. Acta Neurochir (Wien) 121: 187–190
George B, Lot G, Velut S (1993) Pathologie tumorale du foramen magnum. Neurochirurgie 39: 1–89
George B, Lot G (1994) Oblique transcorporeal drilling to treat anterior compression of the spinal cord at the cervical level. Minim Invas Neurosurg 37: 48–52
George B, Lot G (1995) Neurinomas of the first two cervical nerve roots: a series of 42 cases. J Neurosurg 82: 917–923
George B, Lot G (1995) Anterolateral and posterolateral approaches to the foramen magnum: technical description and experience from 97 cases. Skull Base Surg 5(1): 9–19
George B, Lot G (1995) Foramen magnum meningiomas: a review from personal experience of 37 cases and from a Cooperative Study of 106 cases. Neurosurg Q 3: 149–161
George B, Lot G, Tran Ba Huy P (1995) The juxtacondylar approach to the jugular foramen (without petrous bone drilling). Surg Neurol 44: 279–284
George B, Lot G (1997). Lateral approaches. Skull base surgery. Anatomy, biology and technology. In: Tiedeman J (eds) Lipincott-Raven, New York, pp 243–260
George B, Lot G, Boissonnet H (1997) Meningioma of the foramen magnum: a series of 40 cases. Surg Neurol 47: 371–379
George B, Lot G (1997) Cervical neurinomas with extradural component. Surgical management from a series of 57 cases. Neurosurgery 41: 813–822
George B (1998) Management of the vertebral artery in skull base surgery. Surgery of the skull base. In: Paul J Donald (ed) Lippincott-Raven Publishers, Philadelphia, pp 533–553
George B (1998) Exposure of the upper cervical artery. In: Surgery of the craniovertebral junction. In: Curtis A Dickman, Robert F Spetzler, Volker KH Sonntag (eds) Thieme, New York, pp 545–567
George B, Gauthier N, Lot G (1999) Multisegmental spondylotic myelopathy and radiculopathy treated by multilevel oblique corpectomies without fusion. Neurosurgery 44: 81–90
Hadley MN, Spetzler RF, Masferrer R et al (1985) Occipital artery to extradural vertebral artery bypass procedure. Case report. J Neurosurg 63: 622–625
Hakuba A, Komiyama M, Tsujimoto T, Soo Ahn M, Nishirmura S, Ohta T, Kitano H (1984) Transuncodiscal approach to dumb-bell tumours of the cervical spinal canal. J Neurosurg 61: 1100–1106
Hallett JW Jr, Cherry KJ Jr, Pairolero PC et al (1987) Brachio-cephalic reconstruction: operative techniques. In: Sundt TM Jr (ed) Occlusive cerebrovascular disease. Diagnosis and surgical treatment. WB Saunders, Philadelphia, pp 369–384
Hanakita J, Miyake H, Nagayasu S et al (1988) Angiographic examination and surgical treatment of bow hunter’s stroke. Neurosurgery 23: 228–232
Hardin CA, Williamson WP, Streegman AT (1960) Vertebral artery insufficiency produced by cervical osteoarthritic spurs. Neurology 10: 855–858
Hardin CA, Poser CM (1963) Rotational obstruction of the vertebral artery due to rodundancy and extralaminal cervical fascial bands. Ann Surg 158: 133–137
Hasegawa T, Kuboto T, Ito H, Yamamoto S (1983) Symptomatic duplication of the vertebral artery. Surg Neurol 20: 244–248
Heerschaft H, Duus P (1972) Die obstruierenden Erkrankungen der Arteria vertebralis in ihrer zrvikalen Verlaufstrecke. Folia Angiologica 20: 22–32
Holzer FJ (1955) Verschluss der Wirbelsäulenschlagader am Kopfgelenk mit nachfolgender Thrombose durch Seitwärtsdrehen des Kopfes. Eine Gefahr bei Operationen am Hals mit starker Seitwärtsdrehung. Dtsch Z Ges Gerichtl Med 44: 422–426
Kawaguchi T, Fujita S, Hosoda K, Shibata Y, Iwakura M, Tamaki N (1997) Rotational occlusion of the vertebral artery caused by transverse process hyperrotation and unilateral apophyseal joint subluxation. J Neurosurg 86: 1031–1035
Kieffer E, Rancurel G, Richard T (1984) Reconstruction of the distal cervical vertebral artery. In: Berguer R, Bauer RB (eds) Vertebrobasilar arterial occlusive disease. Medical and surgical management. Raven Press, New York pp 265–290
Kimura S, Gomibuchi F, Ikezawa Y, Kaneko F, Uchiyama S, Homma T (1998) Ossification of posterior atlantoaxial membrane. Case illustration. J Neurosurg 89: 491
Kowada M, Yamagushi K, Takahashi H (1972) Fenestration of the vertebral artery with review of 23 cases in Japan. Radiology 103: 343–346
Kriss FC, Schneider RC (1968) The value of vertebral angiography in the treatment of cervical neurinomas. J Neurosurg 28: 29–34
Lasjaunias P, Braun JP, Hassa AN, Moret J, Manelfe C (1980): True and false fenestration of the vertebral artery. J Neuroradiol 7: 157–166
Lasjaunias P, Guilbert-Tranier F, Braun JP (1981) The pharyngo-cerebellar artery or ascending pharyngeal artery origin of the PICA. J Neuroradiol 8: 317–325
Laurian C, George B, Houdart R, Cormier JM (1983) Revascularisation de l’artère vertébrale distale (3e segment). Indications dans le traitement de l’insuffisance vertébro-basilaire. Ann Chir 37: 325–330
Lot G, George B (1999) The extent of drilling in lateral approaches to the cranio-cervical junction area from a series of 125 cases. Acta Neurochir (Wien) 141: 111–118
Mc Cormick P (1996) Surgical management of dumbbell tumors of the cerevical spine. Neurosurgery 38: 294–300
Mapstone T, Spetzler RF (1956) Vertebrobasilar insufficiency secondary to vertebral occlusion from a fibrous band. J Neurosurg 4: 581–583
Margolis MT, Newton TH (1972) Borderlands of the normal and abnormal PICA. Acta Radiol (Diagn) 13: 163–176
Markert JM, Chandler WF, Deveikis JP, Ross DA (1996) Use of the extreme lateral approach in the surgical treatmente of an intradural ventral cervical spinal cord vascular malformation: technical case report. Neurosurgery 38: 412–415
Matsuyama T, Morimoto T, Sakaki T (1997) Comparison of C1–2 posterior fusion and decompression of the vertebral artery in the treatment of bow hunter’s stroke. J Neurosurg 86: 619–623
Meyer JS, Sheeha S, Bauer RB (1960) An arteriographic study of cerebrovascular disease in man. 1. Stenosis and occlusion of the vertebral basilar arterial system. Arch Neurol 2: 27–45
Miyamoto S, Kikuchi H, Nagata I, Akiyama Y, Itoh K, Yamagiwa O, Asahi S (1992) Saphenous vein graft to the distal vertebral artery between C1 and C2 using a lateral-anterior approach. J Neurosurg 77: 812–815
Okuno S, Touho H, Ohnishi H, Karasawa J (1998) Cervical infarction associated with vertebral artery occlusion due to spondylotic degeneration: case report. Acta Neurochir (Wien) 140: 981–985
Powers SR, Drislane TM, Nevins S (1961) Intermittent vertebral artery compression: a new syndrome. Surgery 49: 257–264
Radojevic S, Negovanovic B (1963) La gouttière et les anneaux osseux de l’artère vertébrale de l’atlas. Acta Anat 55: 186–194
Rainer WG, Quianzon EP, Liggett MS, Newby JP, Blooquist CD (1970) Surgical considerations in the treatment of vertebrobasilar arterial insufficiency. Am J Surg 120: 594–597
Schievink WI, Piepgras DG (1991) Cervical vertebral artery aneurysms and arteriovenous fistulae in neurofibromatosis type I: case reports. Neurosurgery 29: 760–765
Selecki BR (1969) The effects of rotation of the atlas on the axis: experimental work. Med J Anst 1: 1012–1015
Sen CN, Sekhar LN (1990) An extreme lateral approach to intradural lesions of the cervical spine and foramen magnum. Neurosurgery 27: 197–204
Sheehan S, Bauer RB, Meyer JS (1960) Vertebral artery compression in cervical spondylosis. Arteriographie demonstration during life of vertebral artery insufficiency due to rotation and extension of the neck. Neurology 10: 968 – 986
Shimizu T, Waga S, Kojima T et al (1988) Decompression of the vertebral artery for bow-hunter’s stroke. Case report. J Neurosurg 69: 127–131
Singer WD, Haller JS, Wolpert SM (1975) Occlusive vertebro-basilar artery disease associated with cervical spine anomaly. Am J Child 129: 492–495
Spinnato S, Talacchi A, Musumeci A, Tuarzzi S, Bricolo A (1998) Dumb-bellshaped hypoglossal neurinoma: surgical removal via a dorsolateral transcondylar approach. A case report and review of the literature. Acta Neurochir (Wien) 140: 827–832
Sundt TMJr, Piepgras DG (1979) Bypass surgery for vertebral artery occlusive disease: technique and complications. Clin Neurosurg 26: 346–352
Tatlow WF, Tissington J, Bammer HG (1957) Syndrome of vertebral artery compression. Neurology 7: 331–341
Verbiest H (1970) La chirurgie antérieure et latérale du rachis cervical. Neurochirurgie 16 [Suppl] n°2: 212
Verbiest H (1973) Anterolateral operations for fracture or dislocation of the cervical spine due to injuries or previous surgical interventions. Clin Neurosurg 20 (27) 334–366
Vishteh AG, Crawford NR, Melton MS, Spetzler RF, Sonntag VK, Dickman CA (1999) Stability of the craniovertebral junction after unilateral occipital condyle resection: a biomechanical study. J Neurosurg 90: 91–98
Willie EJ, Ehrenfeld WK (1970) Surgical techniques in extracranial occlusive cerebro-vascular disease. Diagnosis and management. Saunders Company, London, pp 184–213
Willis BK, Greiner FG, Orrison WW, Benzel EC (1994) The incidence of vertebral artery injury after midcervical spine fracture or subluxation. Neurosurgery 34: 435–442
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George, B. (2002). Extracranial Vertebral Artery Anatomy and Surgery. In: Pickard, J.D., et al. Advances and Technical Standards in Neurosurgery. Advances and Technical Standards in Neurosurgery, vol 27. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6174-6_5
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DOI: https://doi.org/10.1007/978-3-7091-6174-6_5
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