Extradural and hourglass cervical neurinomas: the vertebral artery problem.

Eleven cases of cervical neurinomas with an extradural component were operated on with control of the vertebral artery as the first step of the surgical procedure. The lateral anterior approach was used first in each case with excellent results. In the case of hourglass tumors (seven cases), a complementary posterior approach was performed to remove the intradural portion. Primary control of the vertebral artery in cases of extradural or hourglass neurinoma is a logical and safe procedure in the attempt to achieve complete and bloodless tumor removal.