Anterior Transcorporeal Approach for Cervical Metastatic Melanoma Resection Guided by O-Arm-Navigated Intraoperative Computed Tomography.

BACKGROUND: Surgical resection of the ventrally located tumor in the cervical spinal region is technically challenging and usually requires a traditional extensive approach. To reduce collateral injury and preserve cervical stability, the anterior transcorporeal approach under navigated guidance is an alternative minimally invasive technique. OBJECTIVE: To describe a minimally invasive transcorporeal approach for cervical intradural extramedullary tumor resection and spinal cord decompression. Previous literature regarding available treatment options was reviewed. METHODS: A patient with known intracranial malignant melanoma presented with severe myelopathy from metastatic melanoma compressing the cervical cord. The anterior transcorporeal approach for total tumor resection and spinal cord decompression under a microscope was planned. Under spinal navigation, small bone tunneling was performed to expose and remove the tumor without compromising cervical stability. RESULTS: The melanoma resection was successfully performed without complications. Myelopathic symptoms were significantly improved with the absence of instability or local recurrence at the long-term follow-up. CONCLUSION: We present the anterior transcorporeal approach that can be used to resect the tumor in the ventral cervical region and effectively decompress the cervical cord without complications. Moreover, this approach is the minimally invasive surgical technique that preserves spinal stability, minimizes bleeding, and shortens the hospital stay.