Lateral basal approach for V3 exposure in the supine position.
- 1Department of Neurosurgery, Showa Medical University School of Medicine, Tokyo, Japan.
- 2Department of Neurosurgery, Fujigaoka Hospital, Showa Medical University, 1-30 Fujigaoka, Japan.
Abstract
Background
Exposure of the third segment of the vertebral artery (V3) is occasionally required during posterior fossa surgery to obtain proximal vascular control. Most reported techniques were developed for the lateral or park-bench position and rely primarily on muscular dissection together with complex osseous landmarks. Although the lateral basal approach (LBA), an anatomy-based technique utilizing the deep cervical fascia, has previously been described for the posterolateral craniovertebral junction, its application for V3 exposure in the supine position has not been reported.Methods
We describe a practical application of the previously reported LBA for exposing the V3 segment during posterior fossa surgery performed in the supine position. Sequential development of the lateral basal space through the interlaminar fatty tissue provides a reproducible anatomical corridor to the superior oblique muscle and the C1 transverse process, beneath which the V3 segment is consistently identified.Results
The described anatomical sequence enabled reproducible identification of the V3 segment during posterior fossa surgery in the supine position without additional skin incision, extensive muscle dissection, or patient repositioning.Conclusion
This report illustrates a practical application of the previously described LBA rather than a novel approach to the vertebral artery. Recognition of the anatomical sequence from the interlaminar fatty tissue to the superior oblique muscle and C1 transverse process enables straightforward V3 exposure without altering the operative position and may facilitate proximal vertebral artery control when required during supine posterior fossa surgery.
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BibTeX
@article{arai2026lateral,
title = {{Lateral basal approach for V3 exposure in the supine position.}},
author = {Shintaro Arai and Katsuyoshi Shimizu and Masaki Matsumoto and Akihiro Sakaguchi and Ryo Irie and Yoichi Morofuji},
journal = {Surgical neurology international},
year = {2026},
month = oct,
doi = {10.25259/sni_969_2026},
url = {https://europepmc.org/article/MED/42974293},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Lateral basal approach for V3 exposure in the supine position.
AU - Shintaro Arai
AU - Katsuyoshi Shimizu
AU - Masaki Matsumoto
AU - Akihiro Sakaguchi
AU - Ryo Irie
AU - Yoichi Morofuji
PY - 2026
DA - 2026/10/23
JO - Surgical neurology international
DO - 10.25259/sni_969_2026
UR - https://europepmc.org/article/MED/42974293
AB - Background Exposure of the third segment of the vertebral artery (V3) is occasionally required during posterior fossa surgery to obtain proximal vascular control. Most reported techniques were developed for the lateral or park-bench position and rely primarily on muscular dissection together with complex osseous landmarks. Although the lateral basal approach (LBA), an anatomy-based technique utilizing the deep cervical fascia, has previously been described for the posterolateral craniovertebral junction, its application for V3 exposure in the supine position has not been reported.Methods We describe a practical application of the previously reported LBA for exposing the V3 segment during posterior fossa surgery performed in the supine position. Sequential development of the lateral basal space through the interlaminar fatty tissue provides a reproducible anatomical corridor to the superior oblique muscle and the C1 transverse process, beneath which the V3 segment is consistently identified.Results The described anatomical sequence enabled reproducible identification of the V3 segment during posterior fossa surgery in the supine position without additional skin incision, extensive muscle dissection, or patient repositioning.Conclusion This report illustrates a practical application of the previously described LBA rather than a novel approach to the vertebral artery. Recognition of the anatomical sequence from the interlaminar fatty tissue to the superior oblique muscle and C1 transverse process enables straightforward V3 exposure without altering the operative position and may facilitate proximal vertebral artery control when required during supine posterior fossa surgery.
SN - 2229-5097
SN - 2152-7806
ER -