Excision of a centrally based ventral intradural extramedullary tumor of the cervical spine through a direct posterior approach

Abstract

Subsequent to tumor removal, the patient had complete resolution of his cervicalgia, headaches, and scapular pain by his two month follow-up appointment. Although adhesions can make total resection difficult, a posterior approach can grant adequate access to midline ventral meningiomas. Cervical spine stability, tumor location, infection risk, and surgeon familiarity with the approach should all be weighed in decision-making.

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

“…The surgical choice principally depends upon the location and size of the tumor as well as its characteristics, the spinal stability, the control of the spinal cord (SC), and blood vessels [1,4]. Two principal surgical approaches to access this region have been described, with varying degrees of exposure and approachrelated morbidity: anterior corpectomy with instrumented fusion and posterior or posterolateral approaches [1,2,3].…”

Novel Technique of Coregistered Intraoperative Computed Tomography and Preoperative Magnetic Resonance Imaging and Diffusion Tensor Imaging Navigation in Spinal Cord Tumor Resection

“…Intradural spinal tumors (ISTs), both intradural extramedullary (IDEM) tumors and intramedullary spinal cord tumors (IMSCTs), represent a rare but challenging disease state secondary to local anatomy and proximity of critical structures within a compact and often restricted operative environment. [1][2][3][4][5][6][7][8] Preservation of surgical corridors and identification of normal anatomy often necessitate a generous exposure of intradural anatomy, and tumor localization can be difficult-particularly with IMSCTs that are obscured by a normal-appearing spinal cord. 8 IMSCTs are further complicated by little room for localization error that can lead to profound spinal cord parenchyma damage and devastating complications.…”

“…8 IMSCTs are further complicated by little room for localization error that can lead to profound spinal cord parenchyma damage and devastating complications. [1][2][3][4][5][6][7][8][9][10] The majority of ISTs are benign lesions for which surgical resection remains the frontline therapy. 1 Spinal cord surgeons must therefore possess a thorough understanding of local anatomy, but often that knowledge is not sufficient, so intradural spinal neuronavigation has a clear potential role in guiding intraoperative decision-making.…”