Minimally Invasive Removal of an Intradural Cervical Tumor : Assessment of a Combined Split-Spinous Laminectomy and Quadrant Tube Retractor System Technique

Conventional laminectomy is the most popular technique for the complete removal of intradural spinal tumors. In particular, the central portion intramedullary tumor and large intradural extramedullary tumor often require a total laminectomy for the midline myelotomy, sufficient decompression, and adequate visualization. However, this technique has the disadvantages of a wide incision, extensive periosteal muscle dissection, and bony structural injury. Recently, split-spinous laminectomy and tubular retractor systems were found to decrease postoperative muscle injuries, skin incision size and discomfort. The combined technique of split-spinous laminectomy, using a quadrant tube retractor system allows for an excellent exposure of the tumor with minimal trauma of the surrounding tissue. We propose that this technique offers possible advantages over the traditional open tumor removal of the intradural spinal cord tumors, which covers one or two cervical levels and requires a total laminectomy.

Removal of Cervical Dumbbell Schwannoma in a Single Stage by Posterior Approach

Single staged posterior approach was carried out for three patients of dumbbell shaped schwannomas at the cervical region. Gross total resection was achieved in all of the patients, using a modified posterior midline exposure with hemilaminectomy and complete unilateral facetectorny. This exposure provided contiguous intraspinal, foraminal and extraforaminal access delete up to 2-3cm from lateral dural margin. The vertebral artery could be safely preserved from tumor mass. Although the follow up period is short, three patients showed no postoperative cervical spinalies from these operation. Illustrations of this approach with its possible application is discussed.

Lateral Approach to Ventral Meningioma of the Upper Cervical Spinal Canal

No abstract available.

A Case of Cervical Cord Hemangioblastoma

Solitary intramedullary hemangioblastoma of the high cervical cord is rare. The incidence of spinal cord hemangioblastomas varies from 1.6% to 3% of primary spinal cord tumors. The case report dealt with a small solitary hemangioblastoma of 0.4cm in diameter arising in the intramedullary portion of the high cervical cord. Computerized axial tomograms of the brain including the cervical cord could not detect the tumor and cervical myelograms also failed to identify the mass. However, the vertebral angiography revealed a vascular nodule with abnormally dilated feeding artery arising from the right vertebral artery. The tumor was excised in toto from the surrounding medullary tissue without difficulties. The postoperative course of the patient had been uneventful. The possibility of missing such a small tumor like this one was emphasized.