NEURINOMAS OF THE FIRST 2 CERVICAL NERVE ROOTS - A SERIES OF 42 CASES

A group of 42 patients with C-1 and C-2 neurinomas treated during the 10-year period 1982 to 1992 has been collected, including 25 cases fro m 20 French neurosurgical departments and 17 personal cases from the N eurosurgical Department of the Lariboisiere University Hospital, Paris . Analysis of this series reveals some interesting findings relating t o multiplicity of tumors, extradural extension, and neurofibromatosis. There were seven patients with multiple lesions (bilateral C-2 neurin omas in six cases and two neurinomas at C-2 and one at C-1 in one case ). In the 35 other cases, 16 lesions were entirely extradural and 19 h ad an hourglass configuration. Thirteen patients presented signs of ne urofibromatosis. One lesion had a melanotic form and another was a rad iation-induced schwannoma. Surgical results were excellent in most cas es with no immediate postoperative death. Best results in terms of com plete removal and neurological condition were achieved with posterolat eral or anterolateral surgical approaches (17 cases) as compared with the standard midline posterior route (25 cases).