Posterolateral transpedicular approach for ventrally seated cervicothoracic spinal cord lesions: how I do it

BACKGROUND: Surgical exposure of lower cervical and upper thoracic intradural extramedullary lesions located along the ventral medulla are among the most complexes to address in spinal surgery, and their surgical removal carries a high risk. METHODS: We describe the surgical steps of a posterolateral transpedicular approach for resection of an intradural extramedullary lesion located anterolaterally at C7-T1 level. CONCLUSIONS: A posterolateral transpedicular approach is a safe and efficient surgical corridor to explore the ventral spinal cord and to have a direct access to lower cervical-upper thoracic lesions without the extensive manipulation of the spinal cord and the spine instability. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00701-022-05424-2.