Falcón-Molina Jesús Eduardo, Castillejo-Adalid Luis Alfonso, Lozano-Guzmán Isauro, Velázquez-Castillo Joel Abraham, Correa-Correa Víctor
Department of Neurosurgery, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Mexico City, Mexico.
Surg Neurol Int. 2025 Apr 4;16:124. doi: 10.25259/SNI_1063_2024. eCollection 2025.
C2 nerve root schwannomas are rare and may be hourglass or dumbbell-shaped at the craniocervical junction. We describe the clinical/radiological features and treatment outcomes of patients with dumbbell C2 schwannomas operated through a far lateral approach and the technical details of this approach.
Between 2019 and 2024, seven consecutive patients underwent surgery for dumbbell C2 schwannomas at the Hospital de Especialidades del Centro Médico Nacional Siglo XXI in Mexico City, Mexico. Data regarding clinical presentation, tumor location, and surgical results were investigated retrospectively in institutional databases.
There were 5 males (71.4%) and 2 females (28.5%); the mean age was 50.4 years (range 36-75). The average duration of symptoms before surgery was 16.7 months (range 8-35). Motor deficit (85.7%) and headache (57.1%) were the most frequent symptoms. In all cases, gross total resection (GTR) was successfully achieved. There were no post-surgical complications reported. The mean follow-up time was 21.4 months (range 1-54). Six patients (85.7%) referred completely recovered from their symptoms.
Dumbbell C2 schwannomas pose a surgical challenge due to the adjacent anatomical structures involved. The far lateral approach enables GTR of these tumors with minimal neurovascular manipulation and excellent functional outcomes.
C2神经根神经鞘瘤较为罕见，在颅颈交界处可能呈沙漏形或哑铃形。我们描述了通过远外侧入路手术治疗哑铃形C2神经鞘瘤患者的临床/放射学特征及治疗结果，以及该入路的技术细节。
2019年至2024年期间，墨西哥城墨西哥国立二十一世纪医学中心专科医院连续7例患者接受了哑铃形C2神经鞘瘤手术。在机构数据库中对临床表现、肿瘤位置及手术结果的数据进行回顾性研究。
男性5例（71.4%），女性2例（28.5%）；平均年龄50.4岁（范围36 - 75岁）。术前症状平均持续时间为16.7个月（范围8 - 35个月）。运动功能障碍（85.7%）和头痛（57.1%）是最常见的症状。所有病例均成功实现了全切除（GTR）。未报告术后并发症。平均随访时间为21.4个月（范围1 - 54个月）。6例患者（85.7%）称症状完全缓解。
由于涉及相邻解剖结构，哑铃形C2神经鞘瘤带来了手术挑战。远外侧入路能够以最小的神经血管操作实现这些肿瘤的全切除，并获得良好的功能结果。
