PMC4508739_01
Intraoperative photographs in Patient 1 demonstrating the surgical steps by posterior lateral sulcus approach. A: The spinal cord appeared a little bit swollen. C3 dorsal nerve roots on the left side (*) were identified. B: The opening of the posterior lateral sulcus was made using a diamond knife. C: The myelotomy can be extended rostrally or caudally by meticulously splaying the spinal tissue using a microdissector. D: Careful dissection within the spinal cord revealed the tumor (**)-cord interface with the surrounding hemosiderin stained tissue. E: There was little or no need for further hemostasis after the complete removal of the tumor. F: The shape of the spinal cord was restored by suturing the pial edges together.
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F3
The spinal cord appeared a little bit swollen (Fig. 3A). Careful dissection within the spinal cord revealed the tumor-cord interface with the surrounding hemosiderin stained tissue (Fig. 3C, D). When the removal was complete, there was little or no need for further hemostasis (Fig. 3E).
Patient 1. T2-weighted magnetic resonance (MR) images before surgery demonstrating the extensive enlargement and intramedullary mixed signal of the spinal cord at C2 to C3 (A), which was consistent with blood degradation products and deviated to left side and on T2-weighted images (B). T2-weighted MR images at 2 months after surgery demonstrating satisfactory recovery of intramedullary signal of the spinal cord (C, D).
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F4
T2-weighted MR images (Fig. 4A). T2*-weighted gradient-echo MR images showed mixed low signal within the spinal cord, which was consistent with blood degradation products and deviated to left side and on T2-weighted images (Fig. 4B). T2-weighted MR images at 2 months after surgery revealed satisfactory recovery of intramedullary signal of the spinal cord (Fig. 4C, D).
PMC4508739_02
Intraoperative photographs in Patient 2 demonstrating the surgical steps by posterior lateral sulcus approach. A: The spinal cord appeared a little bit swollen. C3 dorsal nerve roots on the right side (*) were identified. B: The opening of the posterior lateral sulcus was made using a diamond knife. C: The myelotomy can be extended rostrally or caudally by meticulously splaying the spinal tissue using a microdissector. D: The gentle dissection of the tumor-cord interface was continued in the longitudinal plane over the extent of the tumor (**). E: There was usually little or no need for further hemostasis after the complete removal of the tumor. F: The shape of the spinal cord was restored by suturing the pial edges together.
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F5
The spinal cord appeared a little bit swollen (Fig. 5A). Careful dissection within the spinal cord revealed the tumor-cord interface with the surrounding edematous tissue (Fig. 5C, D). When the removal was complete, there was little or no need for further hemostasis (Fig. 5E).
Patient 2. T2-weighted magnetic resonance (MR) images before surgery demonstrating the extensive enlargement and intramedullary high signal of the spinal cord with tumor formation at C2 (A), which was deviated to right side on T2-weighted axial images (B). T2-weighted MR images at 1 month after surgery demonstrating satisfactory recovery of intramedullary signal of the spinal cord (C, D).
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F6
McCormick functional schema and Grade 2 of the sensory pain scale. MR imaging of the cervical spine revealed extensive enlargement and intramedullary high signal of the spinal cord with tumor formation at C2 on T2-weighted MR images (Fig. 6A). Enhanced T1-weighted MR images showed well-enhanced tumor within the spinal cord, which was deviated to right side on T2-weighted axial images (Fig. 6B). T2-weighted MR images at 1 month after surgery revealed satisfactory recovery of intramedullary signal of the spinal cord (Fig. 6C, D).