The safe surgical strategy using preoperative embolization for cervical dumbbell tumor with large vertebral body Involvement: A case report

• Cervical dumbbell tumors extending to the surrounding vertebral body and vertebral artery are a surgical challenge. • Intraoperative blood loss reduction is important for safe tumor resection of extensive cervical spine dumbbell tumors. • Preoperative embolization helped to reduce intraoperative blood loss. • A staged surgery was optional for complex spine tumor surgery. The resection of a cervical spine dumbbell tumor extending into the vertebral body with vertebral artery encasement is a surgical challenge in terms of safe tumor resection with minimal intraoperative blood loss. A seventy-six female patient suffering from left arm pain and progressive myelopathy presented with a cervical spine dumbbell tumor mainly located at the left C3-4 foramen with large C3 and C4 vertebral body involvement and encasement of the left vertebral artery. Because en-bloc tumor resection was difficult due to extensive tumor localization, piecemeal tumor resection by posterior and anterior approach was planned. To reduce intraoperative blood loss and complexity of surgical procedures, she underwent preoperative embolization and staged posterior and anterior surgery. The total tumor resection and spinal reconstruction were successfully carried out with minimal intraoperative blood loss. Although complex tumor resection and reconstruction surgery should be planned on an individualized, case-by-case basis, preoperative embolization is reserved as an option for surgical strategies.