Surgery of cervical spine tumors in the close vicinity to the vertebral artery: literature review

Abstract

Objective. To analyze the literature on cervical spine tumors located in the region of the vertebral artery. Material and Methods. Sixty five publications containing data on the surgical treatment of 101 patients with tumors of the cervical spine located in the area of V1–V3 vertebral artery segments were selected for the literature review. Results. The analysis of publications was performed according to the following criteria: demographic data, complaints, histological type of tumor, involvement of the vertebral artery, the performed occlusion test, final embolization or ligation of the artery during surgery, and postoperative complications. The group of patients described in selected publications consisted of 66 men and 35 women, whose average age at the time of surgery was 38.7 years. Acute development of neurological symptoms at the prehospital stage caused by vertebral artery compression was observed in two cases. The C2–C4 vertebrae were most often affected, and the malignant process was confirmed in 70.3 % of cases. In 27 cases, patients underwent an occlusion test of the involved vertebral artery. At the preoperative stage, the final embolization of the artery was performed in 9 cases, the artery was tied during the main operation and removed together with the tumor – in 25, and damaged – in 7. Neurological disorders associated with stopping blood flow through the vertebral artery were noted in two cases. In a number of cases, patients underwent vascular anastomosis with preservation of blood flow at follow-up examination. Conclusion. Taking into account the obtained data and careful preoperative planning will improve the treatment of this group of patients, increase survival, and reduce the risks of possible neurological disorders and tumor recurrence.