Medical Student San Juan Bautista Escuela De Medicina Caguas, Puerto Rico
Abstract Body : Aim: This study aimed to precisely measure the average length of V segments of the vertebral artery, with a focus on facilitating meticulous preoperative planning for lesions along the foramen magnum anterolateral to the brainstem and the odontoid process of C2. Methods: Twelve formalin-fixed specimens injected using the six-vessel technique were immersed in 70% ethanol for optimal tissue fixation. After a 48-hour waiting period for latex setting, specimens were dissected under microscopic magnification, exposing the vertebral artery. Measurements were taken after opening the foramen of C1 and C2. CT images were analyzed using the EPIC hyperspace production software. A detailed illustration of the measurement process and step-by-step dissection and craniotomy procedures were provided. Results: The mean percentage of vertebral artery mobilization after opening C1 and C2 foramen was 24.8% and 32.3%, respectively. CT scans from 200 patients provided mean lengths for vertebral artery segments. Conclusion:Understanding the patient's unique vertebral artery configuration in comparison to average measurements enhances surgical planning for far lateral approaches. This individualized strategy, mobilizing the vertebral artery instead of navigating around it, improves safety margins and patient outcomes in skull base pathologies. These findings offer valuable insights for optimizing alterations to the far lateral approach, particularly in challenging cases requiring complete exposure.
