The anterior approach to anterior cervical meningiomas: review illustrated by a case.

Anterior cervical meningiomas have traditionally been operated on by a posterior approach. However, several reports of an anterior approach to anterior cervical meningiomas and other anterior cervical intradural lesions have documented important advantages: large bony window of access, extradural coagulation of anterior blood supply to meningiomas, visualization of the intradural pathology in front of the spinal cord, and absence of manipulation of the spinal cord during resection of the lesion. In this study, the literature about anterior approaches to anterior cervical meningiomas is systematically reviewed and the advantages and disadvantages of the technique are discussed. Furthermore, a case of complete resection of a large anterior cervical intradural extramedullary meningioma from C5-7 by a three-level corpectomy with progressive postoperative neurological recovery is illustrated, confirming the advantages of the anterior approach.