Objective: To study the operation of C1-2 dumbbell-shaped tumor, and its effect on the cervical spine stability.
Methods: Different surgical tumor resection was selected according to the tumor size and the invasion scope. Hemilaminectomy was the first choice for the resection of the tumor at intr-extraspinal canal in the conventional prone position. After the tumor was fully revealed, the epidural tumor was removed first with enough space to be vacated, then the subdural section was removed. If the tumor in the spinal canal was more than half of the spinal canal, to prevent spinal cord injury, the part of the C1-2 spinous process base should be removed to facilitate the exposure. Dural defect should be repaired and the muscle sutured to achieve anatomic reduction in order to facilitate the stability of the cervical spine. Lateral approach should be combined to resect the tumor if its total removal was impossible as the tumor had invaded the spinal canal outside over 4 cm or completely surrounded the vertebral artery.
Results: C1-2 dumbbell-type tumors were treated in 16 cases, of which 12 were of schwannoma, 3 of meningioma and 1 of ganglion cell tumor. Total resection was in 14 cases, and subtotal resection in 2. After operation, the symptoms of pain in the neck and upper limb muscle weakness were relieved. All the patients were followed up. The follow-up period was 3-48 months. No cervical spine instability or tumor recurrence was found.
Conclusion: C1-2 dumbbell-shaped tumors could be well resected by poster-median hemilamiectomy approach or joint lateral approach , and the stability of cervical spine could be better maintained at the same time.