Three cases of spinal cord tumor originating from the second cervical nerve root

Determination of the level of spinal cord tumors that develop around the foramen magnum or high cervical region can be difficult, because the symptoms of such tumors are quite variable. The surgical approach to use in such cases remains controversial. We describe here three cases of spinal cord tumor originating from the second cervical nerve root. Initial symptoms included occipital pain, glove-type numbness, and paresthesia of the upper extremities. In all three cases, myelopathic signs preceded radicular signs. It was possible to resect the tumors almost completely by using a posterior approach with microsurgical technique. Several reports have concerned the best surgical approach for high cervical spinal cord tumors. However, by using our method, tumors originating from the C2 root could be exposed without destroying the facet joints, because the nerve root runs dorsal to the lateral facet joints. We therefore recommend resecting these tumors except when they involve the vertebral artery and facet joints.