Intradural Extramedullary Tumor: Cervical

Abstract

Intradural extramedullary tumors of the cervical spine are located within the dural sheath and outside the spinal cord. Nerve sheath tumors, including the subset of dumbbell tumors, and meningiomas make up the vast majority of these tumors. Using standard exposures and microsurgical techniques, it is possible to completely resect these tumors while preserving neurological function in most cases. Timely treatment on appropriate selected patients, combined with a well-developed plan for an operative approach, can lead to gratifying outcomes for both patient and surgeon. While benign, noninvasive, and biologically indolent, these tumors are subject to so many variables that each case must be considered unique. Key considerations of the tumors, including size, axial and sagittal location, origin, attachments, vascularity and consistency, as well as patient conditions and co-morbidities and surgeon preferences and experience, must all be incorporated into the treatment plan. In this chapter, we aim to describe the initial approach, surgical techniques, as well as modifications and pearls in order to optimize surgical management of these tumors.