Surgical approach to C1-C2 nerve sheath tumors.

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dc.contributor.authorKrishnan, Prasaden_US
dc.contributor.authorBehari, Sanjayen_US
dc.contributor.authorBanerji, Deepuen_US
dc.contributor.authorMehrotra, Naveenen_US
dc.contributor.authorChhabra, Devendra Ken_US
dc.contributor.authorJain, Vijendra Ken_US
dc.date.accessioned2004-09-09en_US
dc.date.accessioned2009-06-03T11:11:40Z
dc.date.available2004-09-09en_US
dc.date.available2009-06-03T11:11:40Z
dc.date.issued2004-09-09en_US
dc.description.abstractBACKGROUND: C1 and C2 nerve sheath tumors (NST) are unique in presentation, relationship to neighbouring structures and surgical approaches when compared to their counterparts in other regions of the spine. AIM: The strategies involved in the surgery for C1-C2 NST are discussed SETTING AND DESIGN: Retrospective study. METHODS: 21 patients with C1 (n=6) and C2 (n=15) NST were operated based on their position with respect to the cord i.e. anterior (4), anterolateral (10), posterolateral (5), and posterior (2). The tumors had extra- and intradural components in 20 patients; while in one, the tumor was purely intradural. The operative approaches included the extreme lateral transcondylar approach (3); laminectomy with partial facetectomy (5); laminectomy (11); and, suboccipital craniectomy and laminectomy (2). RESULTS: Total excision was performed in 13 patients; while in 7, a partial extraspinal component, and in 1, a small intradural component were left, in situ. Thirteen patients showed improvement by one or more grades in the Harsh myelopathy score; 2 patients with normal power had significant decrease in spasticity; while 5 maintained their grade. One poor-grade patient succumbed to septicemia. CONCLUSIONS: C1-C2 NST may have exuberant growth due to the capacious spinal canal and the absence of a "true" intervertebral foramen at this level. Surgical approaches are determined by its relationship to the cord. A "T incision" on the dura, the partial drilling of the facets, sectioning of the denticulate ligament, rotating the operating table 15 to 30 degrees, and at times sectioning the posterior nerve roots are all useful adjuncts for facilitating access.en_US
dc.description.affiliationDepartment of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.en_US
dc.identifier.citationKrishnan P, Behari S, Banerji D, Mehrotra N, Chhabra DK, Jain VK. Surgical approach to C1-C2 nerve sheath tumors. Neurology India. 2004 Sep; 52(3): 319-24en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/120727
dc.language.isoengen_US
dc.source.urihttps://neurologyindia.comen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMagnetic Resonance Imagingen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNerve Sheath Neoplasms --epidemiologyen_US
dc.subject.meshNeurosurgical Procedures --methodsen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshSpinal Cord Neoplasms --epidemiologyen_US
dc.subject.meshSpinal Nerve Roots --surgeryen_US
dc.titleSurgical approach to C1-C2 nerve sheath tumors.en_US
dc.typeJournal Articleen_US
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