Marginal En Bloc Resection of C2–C3 Chordoma with Bilateral Vertebral Artery Preservation and Mesh Cage Reconstruction with Review of Previously Published Cases

Chordomas arise from remnants of the notochord and occur throughout the neuroaxis. En bloc resection of chordomas can prove especially challenging in the upper cervical spine secondary to the unique structural anatomy and intimate relationship to the vertebral arteries and spinal cord. We describe t...

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Veröffentlicht in:World neurosurgery 2017-12, Vol.108, p.993.e1-993.e7
Hauptverfasser: Tenny, Steven O., Ehlers, Landon D., Robbins, J. Will, Gillis, Christopher C.
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container_title World neurosurgery
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creator Tenny, Steven O.
Ehlers, Landon D.
Robbins, J. Will
Gillis, Christopher C.
description Chordomas arise from remnants of the notochord and occur throughout the neuroaxis. En bloc resection of chordomas can prove especially challenging in the upper cervical spine secondary to the unique structural anatomy and intimate relationship to the vertebral arteries and spinal cord. We describe the resection of a C2–C3 chordoma in a 55-year-old woman in 2-stage fashion with preservation of the vertebral arteries. First, a posterior instrumented fusion and removal of the posterior elements was performed, followed by an anterior transmandibular en bloc resection with cage reconstruction with kick-plate support achievable with off-the-shelf products. Chordomas in the upper cervical spine pose a surgical challenge but are amenable to en bloc resection. With careful planning and intraoperative adaptability, the surgeon can achieve a suitable reconstruction with off-the-shelf products.
doi_str_mv 10.1016/j.wneu.2017.08.178
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subjects Cage
Cervical spine
Cervical Vertebrae - diagnostic imaging
Cervical Vertebrae - surgery
Chordoma
Chordoma - diagnostic imaging
Chordoma - surgery
Female
Humans
Internal Fixators
Kick-plate
Middle Aged
Reconstruction
Reconstructive Surgical Procedures
Spinal Fusion
Spinal Neoplasms - diagnostic imaging
Spinal Neoplasms - surgery
Vertebral Artery - diagnostic imaging
Vertebral Artery - surgery
title Marginal En Bloc Resection of C2–C3 Chordoma with Bilateral Vertebral Artery Preservation and Mesh Cage Reconstruction with Review of Previously Published Cases
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