Neurinomas of the first two cervical nerve roots: a series of 42 cases.

A group of 42 patients with C-1 and C-2 neurinomas treated during the 10-year period 1982 to 1992 has been collected, including 25 cases from 20 French neurosurgical departments and 17 personal cases from the Neurosurgical Department of the Lariboisière University Hospital, Paris. Analysis of this series reveals some interesting findings relating to multiplicity of tumors, extradural extension, and neurofibromatosis. There were seven patients with multiple lesions (bilateral C-2 neurinomas in six cases and two neurinomas at C-2 and one at C-1 in one case). In the 35 other cases, 16 lesions were entirely extradural and 19 had an hourglass configuration. Thirteen patients presented signs of neurofibromatosis. One lesion had a melanotic form and another was a radiation-induced schwannoma. Surgical results were excellent in most cases with no immediate postoperative death. Best results in terms of complete removal and neurological condition were achieved with posterolateral or anterolateral surgical approaches (17 cases) as compared with the standard midline posterior route (25 cases).