Giant Granular Cell Tumor of the Cervical Spinal Cord Resected via Anterior Corpectomy with Reconstruction: Technical Note and Review of Literature

Spinal intradural extramedullary granular cell tumor

Background:

Granular cell tumors (GCTs) are uncommon peripheral nerve sheath tumors of Schwann cell origin that may occur throughout the body. However, they rarely occur in the spinal canal.

Case Description:

A 49-year-old male presented with burning sensation in the left knee. The MRI of the lumbar spine showed an L3-L4 intradural extramedullary tumor. Complete surgical resection was successfully performed and the L3 root burning improved. Histopathologically, the lesion proved to be a benign GCT.

Conclusion:

Spinal GCTs are rare benign tumors that may be found in an intradural extramedullary location in the spine. The preferred treatment is complete surgical resection as subtotal/partial resection may result in recurrence warranting radiation therapy.

Anterior Transcorporeal Approach for Cervical Metastatic Melanoma Resection Guided by O-Arm-Navigated Intraoperative Computed Tomography

BACKGROUND

Surgical resection of the ventrally located tumor in the cervical spinal region is technically challenging and usually requires a traditional extensive approach. To reduce collateral injury and preserve cervical stability, the anterior transcorporeal approach under navigated guidance is an alternative minimally invasive technique.

OBJECTIVE

To describe a minimally invasive transcorporeal approach for cervical intradural extramedullary tumor resection and spinal cord decompression. Previous literature regarding available treatment options was reviewed.

METHODS

A patient with known intracranial malignant melanoma presented with severe myelopathy from metastatic melanoma compressing the cervical cord. The anterior transcorporeal approach for total tumor resection and spinal cord decompression under a microscope was planned. Under spinal navigation, small bone tunneling was performed to expose and remove the tumor without compromising cervical stability.

RESULTS

The melanoma resection was successfully performed without complications. Myelopathic symptoms were significantly improved with the absence of instability or local recurrence at the long-term follow-up.

CONCLUSION

We present the anterior transcorporeal approach that can be used to resect the tumor in the ventral cervical region and effectively decompress the cervical cord without complications. Moreover, this approach is the minimally invasive surgical technique that preserves spinal stability, minimizes bleeding, and shortens the hospital stay.

Anterior cervical transvertebral approach for resection of an intraspinal ventral lesion: illustrative case

BACKGROUND

The anterior cervical corpectomy and fusion approach has been reported for the removal of ventral cervical tumors. However, the normal cervical vertebral body and the adjacent intervertebral discs have to be sacrificed. In this paper, the authors describe a novel anterior cervical transvertebral approach for the resection of cervical intraspinal ventral lesions.

OBSERVATIONS

A patient presented with an anteriorly placed extramedullary cyst. An anterior cervical transvertebral open-window and close-window approach was designed and applied to resect an intraspinal ventral enterogenous cyst. With this novel technique, a square was cut through the whole vertebral body at the four sides. After the cyst resection, the bone block was restored and fixed with a titanium miniplate. The lesion was totally resected, and the compression of the spinal cord was relieved. The physiological function of the cervical spine was kept intact after the operation. There was no postsurgical complication. The cervical alignment was normal at the 1-year postoperative follow-up.

LESSONS

The anterior cervical transvertebral open-window and close-window approach was developed and confirmed to be effective for the resection of cervical intraspinal lesions. The cervical physiological structure and function can be restored with this new technique.