Surgical Treatment of Craniovertebral Junction Tumor

Clinical Article

Korean J Spine 2005;2(4): 301-306.

Jae-Hyung Cho, M.D., Young-Jin Song, M.D., Hyung-Dong Kim, M.D.

Department of Neurosurgery College of Medicine, Dong-A University, Busan, Korea

두개 경추 이행부 종양에 대한 수술적 치료

최재형^,송영진^,김형동

동아대학교 의과대학 신경외과학교실

Abstract

Objective: The authors reviewed 22 patients of extramedullary spinal cord tumor located at the craniocervical junction between 1994 and 2004. They are 9 meningiomas, 12 neurinomas(7 neurofibromas, 5 schwannomas) and 1 osteochondroma.
Methods: They were evaluated radiologic findings, clinical data and operative notes. The mean follow-up period was 3 years.
Results: The tumors were operated via bilateral laminectomy, laminectomy with suboccipital craniectomy, far-lateral partial transcondylar approach and transoral transpharyngeal approach. So, 21 cases of tumor were removed totally. There was no surgical mortality.
In operation, we could carry out total removal of tumor by piecemeal resection without large condylectomy and facetectomy. And we did not carry out occipitocervical fusion. In long term follow-up, there was no evidence of instability or progressive kyphosis in all patients.
Conclusion: The authors emphasize that preoperative neuroradiological evaluations on presumptive tumor type could be helpful to the surgeon, providing a required minimal exposure, without unnecessary surgical steps.

Keywords: Foramen magnum.Spinal cord tumor.Menigioma.Neurogenic tumor