SURGICAL VIDEO C5-C6 Cervical Spinal Cord Cavernous Malformation Microsurgical Resection: 2-Dimensional Operative Video Alejandro Enriquez-Marulanda, MD , ∗ ‡ Abdulrahman Y. Alturki, MBBS, MSc, FRCSC , ∗ ∗ Kimberly Kicielinski, MD, MPH , Ajith J. Thomas, MD , Christopher S. Ogilvy, MD Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard ‡ Watch now at https://academic.oup.com/ons/article-lookup/doi/10.1093/ons/opy066 Medical School, Boston, Massachusetts; Department of Neurosurgery, The National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia Correspondence: Christopher S. Ogilvy, MD, Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street, Boston, MA 02215. E-mail: firstname.lastname@example.org We describe the case of a previously healthy 44-yr- under neurophysiologic monitoring was performed, and old female patient presenting with a sudden onset of complete resection of the lesion was achieved with mild numbness, paresthesias, and decreased sensation in her improvement of the sensitive symptoms and no evidence lower limbs. Physical examination revealed a decreased of new motor deficits. Any microsurgical resection of sensation to vibration and light touch in her lower extrem- a cervical spinal cord lesion can be technically difficult ities, primarily in the left limb. Impaired proprioception and adequate patient selection with evaluation of the was also evident primarily in the left toe. Full strength accessibility to the lesion is key. Surgical resection of with 2+ reflexes was observed in all extremities. Magnetic cavernous malformations in selected patients eliminates resonance imaging demonstrated an exophytic lesion in theriskoffuturehemorrhageandmayachievesatisfactory the posterior aspect of the cervical spinal cord at the C5-C6 outcomes comparable to patients who undergo conser- level, with a hemosiderin halo, consistent with a cavernous vative management. In the following video illustration, malformation. Given the evidence of past hemorrhage we narrate this operative case, and highlight the nuances and the location of the lesion, microsurgical intervention of this approach. Patient consent was obtained for the was indicated. A midline cervical C5-C6 laminectomy submission of the video to this journal. KEY WORDS: Cavernous malformation, Spinal cord, operative surgical procedure, microsurgery Operative Neurosurgery 16:E7, 2019 DOI:10.1093/ons/opy066 Received, November 27, 2017. Accepted, April 3, 2018. Published Online, April 6, 2018. Disclosure 2. Zhang L, Yang W, Jia W, et al. Comparison of outcome between surgical and conservative management of symptomatic spinal cord cavernous malformations. The authors have no personal, financial, or institutional interest in any of the Neurosurgery. 2016;78(4):552-561. drugs, materials, or devices described in this article. REFERENCES 1. Mitha AP, Turner JD, Spetzler RF. Surgical approaches to intramedullary cavernous malformations of the spinal cord. Neurosurgery. 2011;68(2 Suppl Operative):317-324; discussion 324. OPERATIVE NEUROSURGERY VOLUME 16 | NUMBER 1 | JANUARY 2019 | E7
Operative Neurosurgery – Oxford University Press
Published: Jan 1, 2019
It’s your single place to instantly
discover and read the research
that matters to you.
Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.
All for just $49/month
Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly
Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.
Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.
Read from thousands of the leading scholarly journals from SpringerNature, Wiley-Blackwell, Oxford University Press and more.
All the latest content is available, no embargo periods.
“Hi guys, I cannot tell you how much I love this resource. Incredible. I really believe you've hit the nail on the head with this site in regards to solving the research-purchase issue.”Daniel C.
“Whoa! It’s like Spotify but for academic articles.”@Phil_Robichaud
“I must say, @deepdyve is a fabulous solution to the independent researcher's problem of #access to #information.”@deepthiw
“My last article couldn't be possible without the platform @deepdyve that makes journal papers cheaper.”@JoseServera