• Fengqing Gong, Yongjie Chen, Naichun Yu, Zongguang Li, and Guangrong Ji.
• Department of Orthopedic Surgery, Xiang'an hospital of Xiamen university, Xiamen City, Fujian Province, China.
• Medicine (Baltimore). 2020 Oct 2; 99 (40): e21433.

IntroductionIntradural schwannomas can occur at any level of the spine. According to the literature, approximately 8% of intradural schwannomas occur in the atlantoaxial spine, and these tumors are usually located in the posterolateral or lateral spinal cord. In contrast, tumors in the ventral midline of the spinal cord are relatively rare.Patient ConcernsA 47-year-old female presented with progressively worsening neck pain and paresthesias in both upper and lower limbs for the past 5 years.DiagnosisBased on Magnetic Resonance Imaging and histopathological findings, she was diagnosed with ventral midline primary schwannoma of the cervical spinal cord.InterventionsThe patient was treated with surgical resection.OutcomesFollow-up visit at 2 years after the surgery showed that the patient is neurologically intact and free of disease.ConlusionIn summary, for the tumors in the ventral midline of the atlantoaxial spinal cord, the preferred treatment is complete surgical resection by the posterior approach compared to the anterior approach, which often improves clinical symptoms or achieves a healing effect.

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