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Our common interest in surgery of the vertebral artery was born in 1976, when as residents in the same hospital, we attended an attempt by two senior surgeons to treat an aneurysm of the vertebral artery at the C 3 level. Long discussions had preceded this unsuccessful trial, to decide if surgery was indicated and to choose the surgical route. Finally a direct lateral approach was performed, but access was difficult and correct treatment was impossible, resulting in only partial reduction of the aneurysmal pouch. Following this experience, we decided to seek a regular and well defined approach for exposition of the vertebral artery. Review of the literature indicated some surgical attempts, but the descriptions did not give the impression of safety and reproducibility. No landmark on the described surgical route appeared sufficiently reliable. Henry's anatomical work (1917) gave the only accurate description on vertebral artery anatomy, and it became the basis for our work. When the same patient was referred again one year later, after a new stroke in the vertebro-basilar system, we had behind us repetitive experience on cadavers of an original approach to the distal vertebral artery.

This is the first comprehensive book about surgery on and around the vertebral artery all along its cervical and intracranial course. This vessel has been considered for long as out of surgical reach leaving many different pathologies not or incompletely treated. The surgical exposure and control of the vertebral artery not only permit to treat lesions of the vertebral artery wall or developed in contact to it but also to improve the access to the intervertebral foramen (tumors, osteophytes), to the anterior aspect of the spinal cord (tumors, spondylotic spurs), to the foramen magnum and to the jugular foramen.This book written by leading experts includes all aspects of vertebral artery surgery from anatomy to imaging, surgical techniques and pathologies; it is illustrated by many figures especially operative views and schematic drawings so that the beginner as well as the experienced surgeon find useful information.One of the editors of this book (B. GEORGE) was recently awarded the Olivecrona award for his work on the surgery of the vertebral artery.