Lateral Approach for Anterior and Anterolateral Placed Cervical Meningioma or Schwannoma

Abstract

Introduction Cervical meningioma and schwannoma are benign tumors that may present with a wide variety of clinical features. Surgical treatment of those tumors carries a risk of neurological complications and spinal deformities. Surgical approaches include posterior, anterior, or anterolateral options. This is a Descriptive retrospective clinical case series to evaluate the lateral surgical approach in these tumors. Patients and Methods We reviewed patients who underwent lateral surgery for anterior and anterolateral placed cervical meningioma or schwannoma through the past 7 years. A total of 23 patients including 15 females and 8 males were reported. Mean age was 46 years. The average duration of history was 14.9 months. Fourteen patients had meningioma and 9 had schwannoma. According to the JOA-score 15 were normal, 5 were grade-1 and 3 was grade-2. The following factors were evaluated; age, sex, duration, pathology, levels, topographical locations, neurological status, operative time, blood loss, hospital stay, morbidity, and clinical outcome. Results All patients were operated through the lateral cervical approach. All patients but three had total tumor removal where small fragment were lift due to technical reasons. According to the JOA-score the 15 normal patients remain the same, the 5 grade-1 improved to normal, and the 3 grade-2 patients improved to normal in one and to grade-1 in another. There was no reported major morbidity or mortality. CSF leak into the closed drainage system was reported in 5 patients without serious effects. Conclusions The lateral approach allows for safe and effective removal of anterior and anterolateral placed cervical meningioma or schwannoma. It gives a direct access to tumor without risk of cord manipulation or destabilizing the spine. In addition it gives the same clinical results.as the standard posterior approach.