How I do it: cervical hemangioblastoma resection. Surgical technique and complication avoidance

Abstract

Background: Spinal cord hemangioblastomas are benign, highly vascular neoplasms that affect the brain and, rarely, the spinal cord. They can be solitary or as part of von Hippel-Lindau syndrome. Radiosurgery is not a suitable treatment option. Endovascular embolization can only be adjunct to surgery.

Method: We present a detailed approach to resection of a spinal cord hemangioblastoma. A video demonstrates the microsurgical technique and discusses complication avoidance.

Conclusion: The pitfalls to consider are preservation of normal spinal cord vessels, protection of the pia-arachnoid cleavage plane, and avoidance of tumor piecemeal removal. Careful microsurgical resection and detailed preoperative planning are key.

Keywords: Electrophysiological neuromonitoring; Hemangiobalstoma; Microsurgical resection; Surgery of spinal cord; Von Hippel-Lindau.