The approach to tumor resection in the cervical spine depends on the tumor’s location, size, and relationship to critical structures. Anterior, posterior, or combined approaches may be employed. Anterior approaches are often preferred for ventrally located tumors, allowing direct decompression of the spinal cord and stabilization via corpectomy and fusion. Posterior approaches or combined anteroposterior approaches might be necessary for larger, more extensive tumors or when circumferential decompression is required.

Resection strategies vary from intralesional (debulking within the tumor boundary) to en-bloc resection (removal of the tumor in one piece), depending on the tumor type, extent, and goals of the surgery. En-bloc resection is preferred for primary bone tumors to achieve oncologic margins but is more challenging and may not be feasible for all tumors, particularly metastatic lesions.

These surgeries are technically demanding and involve careful planning. Intraoperative navigation and imaging can be instrumental in achieving precise tumor resection while minimizing harm to adjacent structures. Preserving spinal cord and nerve root integrity is a critical concern, often necessitating advanced neuromonitoring techniques.

Post-resection, spinal reconstruction, and stabilization are crucial, especially if significant bony structures are removed or weakened. This may involve using bone grafts, cages, and spinal instrumentation to ensure structural integrity and promote fusion.

Postoperative management includes pain control, rehabilitation, and in cases of malignancy, coordination with oncology for adjuvant therapies such as radiation or chemotherapy.