Surgery of ventral intradural midline cervical spinal pathologies via anterior cervical approach: our experience

The surgical removal of the cervical intradural pathologies located ventrally carries a high risk. According to the anatomical situation and the increasing experience with anterior cervical approach and corpectomy revealed the reality to remove the ventral midline pathologies this way. The anterior approach which require corpectomy preferable to cervical intradural lesions located ventrally at the midline. In the literature have described anterior approach for intradural cervical lesions in very limited cases.

The authors present five cases of intradural ventral cervical spinal pathologies, where removal was done via anterior cervical approach with corpectomy. Two of the cases were intradural meningeomas, one intramedullary cavernoma, one ventral arachnoid cyst and one malignant neurogenic tumour. The approach was described elsewhere. The corpectomy gave a relatively wide window to explore the pathologies and under operative microscope the local control of removal was fairly well. After the total removal of tumours and cavernoma, and fenestration of arachnoid cyst to the subarachnoid space watertight dural closure was made and the cervical spine was stabilized with autolog iliac bone graft, plate and screws. The recovery of the patients was well and there were no postoperative complications.

The anterior cervical approach with corpectomy seems to be a real and safe way to explore and remove the cervical ventral midline pathologies. Postoperative MRI has a great value in early control after the surgery and for follow up the patients.