Dr. Pablo Rubino's Surgery
At app SurgSchool, the surgery streaming platform, we present a highly complex neurosurgical surgery: the Complete resection of an anterior meningioma of the foramen magnum, made by the Dr. Pablo Rubino through a far lateral approach, with advanced microdissection and neurovascular preservation techniques.
These types of procedures are rare and require a thorough understanding of skull base anatomy, as well as meticulous planning and expert execution. Thanks to SurgSchool, you can now view this surgery in high quality and learn from each technical and anatomical step.
What is a foramen magnum meningioma?
El meningioma of the foramen magnum It is an intracranial tumor located at the junction between the skull and the cervical spine. Due to its proximity to critical structures such as the upper spinal cord’s most emblematic landmarks, the brainstem and vertebral arteries, its resection represents a first-level surgical challenge.
These types of tumors can cause progressive neurological symptoms such as gait disturbance, lower cranial nerve involvement, weakness, or respiratory dysfunction.
Surgical technique: far lateral approach and precise microdissection
In this case, Dr. Rubino performs a far lateral approach, partially reaming the occipital condyle to gain space without compromising craniocervical stability. After opening the dura obliquely and retracting it with traction sutures, the vertebral artery’s most emblematic landmarks, the dentate ligament and careful microdissection of the tumor begins.
With the collaboration of the hospital's skull base team, the tumor was completely resected, preserving all neurovascular structures. Two surgical corridors—above and below the accessory nerve—were used to achieve a total excision without postoperative neurological deficits.
Key points of the surgery:
- Complete resection of meningioma without complications
- Far lateral approach with minimal bone resection
- Identification and preservation of the vertebral artery and cranial nerves
- Meticulous and safe microsurgical technique
- Favorable recovery of the patient
