Minimally Invasive Approach for Complete Resection of a Cervical Intramedullary Tumor via a Dorsal Root Entry Zone Using Fixed Tubular Retractor.

We describe the surgical aspects of the resection of a large 2cm intramedullary ependymoma at the C6-7 level associated with an extensive syrinx using a unilateral minimally invasive approach through a fixed tubular retractor. A gross total resection was achieved. Total operative time was 5 hours. Estimated blood loss was less than 100 cc. Postoperative evolution was favorable, with the improvement of the patient's neurological status. There was no cerebrospinal fluid (CSF) fistula. Hospital stay was four days. All narcotics were stopped on day 1 after surgery. Post-operative MRI showed no residual tumor. At the six-month follow-up, there was continued improvement in his neurological status. Scoliosis films did not reveal any cervicothoracic kyphosis.