Modified curvilinear incision for the far lateral approach: A case series

Background and objectives. This study describes a modified curvilinear incision for the far lateral approach. The surgical outcomes and complications are discussed. Methods Cases operated in our institute from 2018 to 2025 were retrospectively collected from a prospectively maintained electronic database. Preoperative, operative, and postoperative data were analyzed. Results Twenty-seven patients were included, and the mean age at the time of surgery was 49.2 ± 11.2 (range 26–69) years. Foramen magnum meningiomas were the most common pathology (17 patients). Gross total resection was achieved in 25 cases. One patient developed a pseudomeningocele and and no cases of cerebrospinal fluid (CSF) leak were observed. After a mean follow-up of 11 months (range 1–52 months), none of the patients required a permanent feeding tube. Conclusion The modified curvilinear incision is a feasible and safe option for the far lateral approach, with a low incidence of approach-related complications in this case series. Further comparative studies with larger cohorts are warranted to evaluate its potential advantages over conventional incisions.