BACKGROUNDSince there are a complex anatomic structure and vital function in the high cervical spinal cord, it is difficult to remove the tumors lateroventral and ventral to the high cervical spinal cord. This clinical study was undertaken to analyze surgical approaches, manner of tumor resection and postoperative management.

METHODSThirty-four patients underwent microsurgical excision of tumors lateroventral and ventral to the high cervical spinal cord by means of three approaches. The tumors comprised mostly Schwannoma and meningioma (88.24%, 30/34) in this group. Tumor volume varied from 3.0 cm x 2.5 cm x 2.0 cm to 12 cm x 3.0 cm x 2.5 cm. Of the 34 patients, 4 had dumbbell-shaped tumors growing outside the spinal canal and 7 tumors growing into the intracranium.

RESULTSThe tumor was totally removed in 32 patients (94.1%). Follow-up for 7 months to 6.4 years (median 3.6 years) showed a recovery of a normal life or work ability in 30 (83.3%) patients.

CONCLUSIONModified operative approaches and microsurgical techniques can raise the rate of total tumor removal and reduce the disability of patients.