Posterior Approach for Microsurgical Resection of a Ventrolateral Cervical Ganglioneuroma: an Illustrative Case and Technical Report

Ganglioneuromas of the cervical spine are exceptionally rare, well-differentiated neuroblastic tumors. We present the case of a 4-year-old female with a several-month history of progressive fatigue, right upper extremity weakness, and gait instability, in whom MRI demonstrated a homogeneously enhancing, cervical intradural extramedullary mass causing significant ventral spinal cord compression. A posterior midline approach with cervical two to cervical six laminoplasty was performed under continuous neurophysiological monitoring, providing wide dorsal access to the lesion. Microsurgical resection of the ventrolateral mass was accomplished using careful arachnoid dissection and cerebrospinal fluid drainage to achieve gross total resection, with histopathology confirming mature ganglioneuroma without malignant transformation. A postoperative MRI demonstrated gross total resection of the mass. At the 6-month follow-up, the patient has demonstrated marked neurological recovery, with full upper extremity strength and normal gait. This case offers a reproducible procedural framework for ventrolateral intradural cervical tumors in the pediatric population while underscoring the importance of multidisciplinary planning, laminoplasty-based posterior corridor selection, and meticulous microsurgical technique.