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 |
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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 |
format | Article |
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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.</description><identifier>ISSN: 1878-8750</identifier><identifier>EISSN: 1878-8769</identifier><identifier>DOI: 10.1016/j.wneu.2017.08.178</identifier><identifier>PMID: 28889042</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>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</subject><ispartof>World neurosurgery, 2017-12, Vol.108, p.993.e1-993.e7</ispartof><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-27fd7b0775d649b8c5aef27115af93d762c633606271f27a5a92db387b6c2a473</citedby><cites>FETCH-LOGICAL-c356t-27fd7b0775d649b8c5aef27115af93d762c633606271f27a5a92db387b6c2a473</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.wneu.2017.08.178$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28889042$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tenny, Steven O.</creatorcontrib><creatorcontrib>Ehlers, Landon D.</creatorcontrib><creatorcontrib>Robbins, J. Will</creatorcontrib><creatorcontrib>Gillis, Christopher C.</creatorcontrib><title>Marginal En Bloc Resection of C2–C3 Chordoma with Bilateral Vertebral Artery Preservation and Mesh Cage Reconstruction with Review of Previously Published Cases</title><title>World neurosurgery</title><addtitle>World Neurosurg</addtitle><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.</description><subject>Cage</subject><subject>Cervical spine</subject><subject>Cervical Vertebrae - diagnostic imaging</subject><subject>Cervical Vertebrae - surgery</subject><subject>Chordoma</subject><subject>Chordoma - diagnostic imaging</subject><subject>Chordoma - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Internal Fixators</subject><subject>Kick-plate</subject><subject>Middle Aged</subject><subject>Reconstruction</subject><subject>Reconstructive Surgical Procedures</subject><subject>Spinal Fusion</subject><subject>Spinal Neoplasms - diagnostic imaging</subject><subject>Spinal Neoplasms - surgery</subject><subject>Vertebral Artery - diagnostic imaging</subject><subject>Vertebral Artery - surgery</subject><issn>1878-8750</issn><issn>1878-8769</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1DAUhSMEolXbF2CBvGQzwT8T25HYtFELSK2KKmBrOfZNx6NMXOxkRt3xDrwBj9Yn6U2ndIk3Pro65_PPKYp3jJaMMvlxXe4GmEpOmSqpLpnSr4pDppVeaCXr1y-6ogfFSc5rikuwpVbibXHAtdY1XfLD4u-VTbdhsD05H8hZHx25gQxuDHEgsSMNf_j9pxGkWcXk48aSXRhX5Cz0doSEoZ-QRmhndYoi3ZNvCeNpa58AdvDkCvKKNPYWEOzikMc07elPpBvYBtjNJ2FwG-KUe2RMbR_yCjzmMuTj4k1n-wwnz_tR8ePi_HvzZXF5_flrc3q5cKKS44KrzquWKlV5uaxb7SoLHVeMVbarhVeSOymEpBJnOLeVrblvhVatdNwulTgqPuy5dyn-miCPZhOyg763A-DFDKsFwhWXs5XvrS7FnBN05i6FjU33hlEz12PWZq7HzPUYqg3Wg6H3z_yp3YB_ifwrAw2f9gbAV-K_JJNdgMGBDwkrMT6G__EfAQmdo6M</recordid><startdate>201712</startdate><enddate>201712</enddate><creator>Tenny, Steven O.</creator><creator>Ehlers, Landon D.</creator><creator>Robbins, J. Will</creator><creator>Gillis, Christopher C.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201712</creationdate><title>Marginal En Bloc Resection of C2–C3 Chordoma with Bilateral Vertebral Artery Preservation and Mesh Cage Reconstruction with Review of Previously Published Cases</title><author>Tenny, Steven O. ; Ehlers, Landon D. ; Robbins, J. Will ; Gillis, Christopher C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-27fd7b0775d649b8c5aef27115af93d762c633606271f27a5a92db387b6c2a473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Cage</topic><topic>Cervical spine</topic><topic>Cervical Vertebrae - diagnostic imaging</topic><topic>Cervical Vertebrae - surgery</topic><topic>Chordoma</topic><topic>Chordoma - diagnostic imaging</topic><topic>Chordoma - surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Internal Fixators</topic><topic>Kick-plate</topic><topic>Middle Aged</topic><topic>Reconstruction</topic><topic>Reconstructive Surgical Procedures</topic><topic>Spinal Fusion</topic><topic>Spinal Neoplasms - diagnostic imaging</topic><topic>Spinal Neoplasms - surgery</topic><topic>Vertebral Artery - diagnostic imaging</topic><topic>Vertebral Artery - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tenny, Steven O.</creatorcontrib><creatorcontrib>Ehlers, Landon D.</creatorcontrib><creatorcontrib>Robbins, J. Will</creatorcontrib><creatorcontrib>Gillis, Christopher C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>World neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tenny, Steven O.</au><au>Ehlers, Landon D.</au><au>Robbins, J. Will</au><au>Gillis, Christopher C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Marginal En Bloc Resection of C2–C3 Chordoma with Bilateral Vertebral Artery Preservation and Mesh Cage Reconstruction with Review of Previously Published Cases</atitle><jtitle>World neurosurgery</jtitle><addtitle>World Neurosurg</addtitle><date>2017-12</date><risdate>2017</risdate><volume>108</volume><spage>993.e1</spage><epage>993.e7</epage><pages>993.e1-993.e7</pages><issn>1878-8750</issn><eissn>1878-8769</eissn><abstract>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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28889042</pmid><doi>10.1016/j.wneu.2017.08.178</doi></addata></record> |
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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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