Anterolateral approach for cervical spinal cord tumors via an anterior microforaminotomy: technical note.
A cervical spinal cord tumor located anteriorly to the spinal cord is conventionally approached through an anterior vertebrectomy followed by bone-graft reconstruction. In order to make a surgical approach minimally invasive, an anterior microforaminotomy technique is used for removal of a tumor located anterior to the spinal cord. When the senior author's experience increased with anterior microforaminotomy for cervical radiculopathy and myelopathy, it was observed that intradural pathology could also be taken care of through the anterior microforaminotomy which did not require bone fusion or postoperative immobilization. For tumor resection, the anterior foraminotomy is made like a flask-shaped hole, with a smaller outer opening similar to that for radiculopathy but incorporating a larger inner opening to accommodate the extent of the tumor in a longitudinal and transverse dimension. The surgical technique is described with two illustrated patients. Postoperatively, the patients did not require a cervical brace. Although their postoperative discomfort was minimal, they were kept in the hospital overnight postoperatively. Spinal stability was well maintained 6 weeks postoperatively. Postoperative imaging of the spine confirmed resection of the tumors. Anterior microforaminotomy is a minimally invasive microsurgical technique which can provide safe and successful removal of tumors located anteriorly to the spinal cord.
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Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pennsylvania, USA. hdjho@neuronet.pitt.edu
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D002574:Cervical Vertebrae / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000517:prevention & control; D008297:Male; D008579:Meningioma / Q000601:surgery; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009455:Neurofibroma / Q000601:surgery; D019635:Neurosurgical Procedures / Q000379:methods*; D013116:Spinal Cord / Q000601:surgery*; D013120:Spinal Cord Neoplasms / Q000601:surgery*; D016896:Treatment Outcome