Ganglioneuromas are benign, slow-growing tumors originating from sympathetic nerves or peripheral nerves, often associated with multiple tumor syndromes. They occasionally occur as spinal lesions and grow within the spinal canal or as paraspinal lesions. In this report, we describe a rare solitary ganglioneuroma arising from the cervical nerve root (C8) within the intervertebral foramen in adults. The tumor could be detected as a mass limited to the neuroforamen at an early stage by MR images. Unilateral microsurgical foraminotomy and EN BLOC resection of the tumor resulted in disappearance of the symptoms. Microsurgical resection of the relevant nerve root through limited medial foraminotomy at an intricate anatomical region of the cervico-thoracic junction was appropriate in the current case for complete resection of the tumor as well as to prevent postoperative structural weakness that could result in late segmental instability.

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Dumb-bell tumours often require extended resection of osseous structures of the spine and subsequent anterior and/or posterior stabilization. Minimally addressed microsurgical intraneural extracapsular resection of a neurinoma originating from around the neuroforamen often provides immediate benefits. We describe our experience with microsurgical intraneural extracapsular resection of four cervical dumb-bell neurinomas in four patients. After a 4- to 7-cm skin incision, a small resection of the laminae and neuroforamen allowed visualisation of the tumour. The procedure was followed by microsurgical intraneural extracapsular complete "enucleation" resection of the tumour, without sacrificing motor funiculi or causing damage to surrounding arteries and radicular veins. One patient had a giant neurinoma at the C5-C6 and C6-C7 foraminal levels that required simultaneous anterior fusion at C5-C6 level only. The average blood loss during surgery was 35 mL (range: 11-59) and all showed neurological improvement immediately after surgery. Minimally addressed microsurgical intraneural extracapsular "enucleating" resection of tumours around the neuroforamen may be beneficial for patients, is not associated with vascular morbidity, and avoids the subsequent need for extensive spinal instrumentation.