This approach is a less-invasive option to remove selected dumbbell lesions that extend beyond and enlarge the intervertebral foramina, with preservation of the spinal integrity.

A 3-D video shows the case of a 35-year-old woman with a 3-month history of progressive, severe cervical and right shoulder pain and numbness in the right arm from a cervical spinal tumor lateral to the spinal cord, and with an extraspinal extension through the enlarged C3 foramen. Through an anterolateral transforaminal approach, the extraspinal tumor was removed by dissecting the plane between the sternocleidomastoid muscle and the internal jugular vein, and then the corridor provided by the enlarged C3 foramen allowed for adequate space for intraspinal tumor dissection, including the intradural component. Postoperative CT scan demonstrated intact bony elements of the C3 segment, and MRI images showed complete tumor removal. The patient had a good postoperative recovery ¹⁾.