Gamma-Knife Radiosurgery of Upper Cervical Spinal Cord Tumor

ABSTRACT

OBJECTIVE: The lower limit of gamma knife radiosurgery is considered as foramen magnum. The head is long and narrow in western people, however, the head is short and wide in oriental people. In microcephalic oriental person, gamma knife radiosurgery is tried for the upper cervical cord tumor. METHODS: We have treated seven patients of upper cervical cord tumor with Gamma-plan during the last 8 years. The seven patients consisted of one man and six women, and ages ranging from 25 to 67 years. The histologic diagnoses were cervicomedullary hemangioblastoma in two, meningioma in two, brain stem glioma extending to C2 in one, hemangioma in one, glomus jugulare tumor in one. Preradiosurgical surgical intervention was performed in three patients. Mean marginal dose was 10.8Gy. RESULTS: The median follow-up period was 40 months (12-51 months). Four tumor had markedly decreased in size on follow-up magnetic resonance image. The remaining four cases were stationary in size. There was no complication. CONCLUSION: In microcehalic or normocephalic oriental person, the lower limit of gamma knife radiosurgery is level of second cervical spine.