The suboccipital transcondylar approach to the clivus and cranio-cervical junction for ventrally placed pathology at and above the foramen magnum

Summary The dorsolateral suboccipital transcondylar approach for pathology anterolateral or ventral to the neuraxis around the lower clivus and brainstem was used in 10 patients with a variety of different pathological problems. Key features of the approach include exposure and mobilisation of the vertebral artery and resection of the postero-medial portion of the atlanto-occipital joint. Despite the excellent access achieved additional exposure may be required in some patients with strictly anterior pathology or a lesion above the mid-clivus.