64 Diagnosis Premedullary cervical meningioma removed through anterior transcorporeal approach Problems and Tactics A premedullary anterior middle (C5–C6) cervical meningioma with symptoms and signs of spinal cord compression was found in a 70-year-old man. Due to the strict anterior-median location and because of an important protrusion of the tumor inside the ventral aspect of the spinal cord, a transcorporal cervical approach was decided upon for surgical removal. The steps included cervical corpectomy through an anterolateral (right) cervical approach, intradural gross tumor resection, and cervical interbody fusion with iliac crest autogenous graft and plate fixation. Keywords Premedullary cervical meningioma, spinal meningiomas, cervical spinal corpectomy, fixation This 70-year-old man with a 3-year history of distal and numbness in the upper and lower extremities was referred because he presented disabling weakness in his left leg and burning pain in the left shoulder for 9 months. Clinical examination found left leg paresis (4/5) with propioceptive deficit in the lower extremities. Magnetic resonance imaging (MRI) showed a C5 and C6 premedullary, well-demarcated midline located mass compressing and displacing posteriorly the anterior aspect of the spinal cord. This lesion, suspected to be a meningioma tumor, was occupying nearly all the spinal canal (Fig. 64–1).
Spinal Meningioma
Clinical Presentation
Surgical Technique
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