Surgical management of cervical neurinomas with extraspinal extension

Neurinomas are the most common type of tumor that cause medullary compression at the cervical level. About 15% of all cervical neurinomas have extradural and extraspinal extension. Their resection raises the problems of nerve root preservation, vertebral artery control and spinal stability. Three patients with cervical neurinomas with significant exstraspinal components are presented in this report. They all had raducular pains and signs of medullary compression. Preoperative neuroimaging revealed cervical intraspinal and extramedullary mass with extraspinal extension. Complete tumor resection was achieved in all three patients by using staged posterior and anterolateral approach. Postoperative results were favorable. The complete removal of cervical neurinomas with extraspinal components is still a real surgical challenge. They can be completely resected by using staged posterior and anterolateral approach.