A quantitative cadaveric study comparing three surgical corridors to the foramen magnum region.

Blue, Zhou, Bond, Ajmera, Youssef and colleagues compared the endoscopic endonasal far-medial, far-lateral transcondylar and combined approaches using volumetric analysis and measurements of surgical maneuverability.

The far-lateral corridor provided the greatest freedom of movement, whereas the endonasal route offered a direct trajectory to the anteromedial compartment. The combined approach provided the largest overall exposure volume.

Why it matters

This study offers a useful quantitative framework for selecting approaches to foramen magnum and ventral craniovertebral junction lesions. It clearly demonstrates that exposure and maneuverability are not interchangeable and that corridor selection should be tailored to lesion location.

Reference

Blue R, Zhou Y, Bond K, Ajmera S, Youssef AS, et al.
Comparative analysis of endoscopic endonasal far-medial, far-lateral transcondylar and combined approaches to the foramen magnum region: volumetric analysis and quantitative insights on surgical exposure and maneuverability.
Acta Neurochirurgica. Published September 28, 2026.
DOI: 10.1007/s00701-026-07039-3