C2 neurofibroma excision: An illustrative video

Abstract

Spinal neurofibromas are rare, benign tumors that can occur sporadically or in association with neurocutaneous
syndromes. These tumors may remain asymptomatic for extended periods, often growing to form a characteristic
dumbbell shape as they extend through intervertebral foramina. Dumbbell-shaped neurofibromas of the upper
cervical nerve roots pose a particular surgical challenge due to their proximity to critical structures like the vertebral
artery. This case report presents a 36-year-old male who developed progressive neck pain, upper limb weakness,
and worsening gait due to a large C2 dumbbell-shaped neurofibroma. C1–C2 laminectomy and near-total excision
of the lesion were done. Gradual recovery of motor function was observed over follow-up. This report underscores
the complexities of managing C2 nerve root neurofibromas, emphasizing their potential for significant neurological
deficits despite their benign nature.