To investigate the feasibility and clinical effect of hemi-resection of posterior arch of atlas in the upper cervical spinal dumbbell-shaped schwannomas.
A retrospective analysis was performed on 13 patients with high level cervical dumbbell schwannomas from January 2005 to December 2018, including 10 males and 3 females, aged 19 to 67 years old. The occipital foramen to the C were 4 cases and 9 cases of C. Tumors were removed by posterior arch of the atlas resection without internal fixation. The clinical efficacy was evaluated by visual analogue pain scale (VAS), Japanese Orthopaedic Association (JOA) scores, and American Spinal Injury Association(ASIA) ratings.
The operation was successfully completed in 13 cases of this group. No vertebral artery injury or spinal cord injury occurred during the operation. All 13 patients were followed up for more than 12 months. No local recurrence was found. Both the VAS and the JOA score were significantly improved compared with those before surgery. The ASIA classification before operation was:1 case of grade C, 6 cases of grade D, 6 cases of grade E;the latest follow up was 3 cases of ASIA grade D and 10 cases of E.
The posterior arch of the atlas hemisection can remove the upper cervical dumbbell schwannoma in one stage. The short-term clinical effect is good, and there are no complications such as cervical instability.