The safe surgical strategy using preoperative embolization for cervical dumbbell tumor with large vertebral body Involvement: A case report

Abstract

Background

The resection of a cervical spine dumbbell tumor extending into the vertebral body with vertebral artery encasement is a surgical challenge in terms of safe tumor resection with minimal intraoperative blood loss.

Case presentation

A seventy-six female patient suffering from left arm pain and progressive myelopathy presented with a cervical spine dumbbell tumor mainly located at the left C3-4 foramen with large C3 and C4 vertebral body involvement and encasement of the left vertebral artery. Because en-bloc tumor resection was difficult due to extensive tumor localization, piecemeal tumor resection by posterior and anterior approach was planned. To reduce intraoperative blood loss and complexity of surgical procedures, she underwent preoperative embolization and staged posterior and anterior surgery. The total tumor resection and spinal reconstruction were successfully carried out with minimal intraoperative blood loss.

Conclusion

Although complex tumor resection and reconstruction surgery should be planned on an individualized, case-by-case basis, preoperative embolization is reserved as an option for surgical strategies.