Objectives: Being surgery the main treatment for chordomas, the elected approach represent a key part on the potential success of the surgery that would define not only the outcome in terms of survival but also the quality of life of these patients. The aim of this presentation is to show an Extreme Far Lateral transodontoid approach for resection of chordoma in the craniocervical junction and clivus as a valid alternative for tumors in this location

Methods: We present a case a 8 yo girl with a tumor that extends from the middle clivus down to the bottom of C2 and posterior to both condyles and lateral masses of C1.

Results: The video shows a microscopic extreme far lateral approach with transposition of the vertebral artery and resection of the Lateral mass of C1, Condyle and odontoid. This approach provides a nice working corridor that allows the resection of large clival tumors invading the craniocervical junction.

Conclusions: The Extreme Far lateral transodontoid approach constitutes a good alternative for large clival tumors that invade the craniocervical junction.