In 1986, Heros 1) introduced the far-lateral approach (FLA) for the management of the vertebral artery aneurysms (VA), the vertebrobasilar junction, and the proximal basilar trunk and for arteriovenous malformations of the inferolateral cerebellum.
In 1988, George et al. introduced the FLA for removal of lesions involving the anterior/anterolateral foramen magnum 2).
Wiltse and Spencer described the paraspinal approach for managing extra-foraminal discs in 1988.
Al-Mefty et al., reported in 1988 thirteen patients harboring large petroclival meningiomas, there was no mortality, and total removal was achieved in all but two patients. Morbidity included cranial nerve deficit, pulmonary embolism, and hemiparesis 3).