Uni-portal non-coaxial spinal endoscopic surgery (UNSES) for resection of a schwannoma in the C1-C2 foraminal region: experience in endoscopic resection and a case report

Schwannomas in the upper cervical spine are relatively rare in clinical practice. Symptomatic patients require surgical resection, which is technically demanding; in some cases, combined cervical internal fixation is needed to maintain stability, and postoperative quality of life may be significantly affected. Uni-portal non-coaxial spinal endoscopic surgery (UNSES) provides a new option for the resection of such tumors. This study reports the case of a patient with an Eden type III C1-C2 schwannoma who underwent UNSES. The patient was a 47-year-old female admitted with a chief complaint of bilateral hand numbness accompanied by neck and back pain persisting for over four months. We precisely and effectively resected the schwannoma using UNSES, with preservation of cervical stability and no requirement for cervical internal fixation. At the three-month follow-up, the patient's Visual Analog Scale for pain decreased from 8 preoperatively to 1, the Japanese Orthopaedic Association score improved from 12 preoperatively to 16, and the Neck Disability Index declined from 23 preoperatively to 7. No postoperative complications occurred. UNSES enables the resection of schwannomas, offering the advantages of minimal invasiveness and rapid recovery. It holds potential benefits for the resection of spinal schwannomas, including those in the upper cervical spine, and provides a valuable reference for the selection of treatment strategies for schwannoma management.