Haemostasis based on topographic anatomy in removal of upper cervical schwannomas extending into the anterior internal vertebral venous plexus

Abstract

Background: The anterior internal vertebral venous plexus (AIVVP) is prominent in the ventral aspect of the upper cervical spine. Therefore, removal of schwannomas extending into the AIVVP may result in massive bleeding.

Technical Note: In five patients with C2 schwannomas, we covered the bleeding hole of the AIVVP with a wide gelatin sponge soaked in fibrin glue, and haemostasis was achieved.

Conclusions: Rather than being comprised of tiny veins, the AIVVP occupies a wide space between the two layers of the posterior longitudinal ligament. In this case, it resembles a sinus. Understanding the topographic anatomy of AIVVPs helps to control bleeding at the site.