C6 cervical osteoma - Overview

26 yr old male with severe neck pain radiating to Right arm since last 2 years. Mri and ct cervical spine suggestive of c6 transverse process osteoma near vertebral artery compressing on nerve root. Patient was taking daily painkillers but no relief, he was almost suicidal due to pain. He was given conservative management because of risky location of tumor. Challenges 1) tumor was compressing on vertebral artery any bleeding from them would be almost unstoppable from posterior approach. 2) tumor was situated anterior to lateral mass, removing it from posterior was very difficult
Strategies:- 1) partial drilling of c6 lateral mass was done. 2) table tilted to opposite side to visualize tumor. Luckily it was osteoma not and was fragile , not adherent to vertebral artery. Postop patient doing well and no pain, not taking any painkiller since surgery