Department of Clinical Neurosciences, Unit of Neurosurgery, Lausanne University Hospital, Lausanne, Switzerland.
Division of Clinical Pathology, Viollier Laboratory, Geneva, Switzerland.
Neurosurg Rev. 2024 Nov 4;47(1):834. doi: 10.1007/s10143-024-03065-w.
Cervical foraminal chondromas are benign lesions that may require surgical resection when symptomatic due to radicular and/or spinal cord compression. The aim of surgery is to achieve gross tumor removal while preserving neurological function and spine stability. The authors describe a case of subaxial foraminal chondroma with a systematic review of the literature on patients with cervical chondromas. In the reported case, the authors used a retrojugular approach to remove a C6-C7 right chondroma without the need for spinal stabilization. Literature review identified a total of 11 patients who underwent surgery for subaxial foraminal chondroma. The mean age at diagnosis is 33.6 years (range: 10-73). Most patients report neurological symptoms at the time of diagnosis. The most frequently involved vertebral level is C4-C5 (54.6%, 6/11). Preoperative foraminal enlargement is present in 63.6% (7/11) of patients. Surgical resection is performed via an anterior approach in 18.2% (2/11) of patients, with vertebral body resection and concomitant cervical instrumentation. The anterolateral approach is selected in 27.2% (3/11) of patients, and the posterior approach in 54.6% (6/11) of patients, with only one patient requiring both anterior and posterior instrumentation. The choice of surgical access for subaxial foraminal chondroma can be challenging due to the anatomical location of the tumor in relation to the cervical nerve roots and spinal cord. Accurate approach selection is key to achieving complete tumor removal while preserving cervical spine stability.
颈椎管内脊索瘤是良性病变，当由于神经根和/或脊髓受压而出现症状时，可能需要手术切除。手术的目的是在保留神经功能和脊柱稳定性的同时实现肿瘤的大体切除。作者描述了一例下颈椎管内脊索瘤病例，并对颈椎脊索瘤患者的文献进行了系统回顾。在报告的病例中，作者采用颈后入路切除 C6-C7 右侧脊索瘤，无需脊柱稳定。文献回顾共确定了 11 例接受下颈椎管内脊索瘤手术的患者。诊断时的平均年龄为 33.6 岁（范围：10-73 岁）。大多数患者在诊断时报告有神经症状。最常受累的椎体水平为 C4-C5（54.6%，6/11）。术前椎间孔扩大见于 63.6%（7/11）的患者。18.2%（2/11）的患者采用前路手术切除，切除椎体并同时行颈椎内固定。27.2%（3/11）的患者选择前外侧入路，54.6%（6/11）的患者选择后路，仅有 1 例患者需要前路和后路同时内固定。由于肿瘤与颈神经根和脊髓的解剖位置关系，下颈椎管内脊索瘤的手术入路选择具有挑战性。准确的入路选择是实现肿瘤完全切除和保留颈椎稳定性的关键。
