Barrey Cédric, Saint-Pierre Ghislaine, Frappaz Didier, Hermier Marc, Mottolese Carmine
Department of Neurosurgery, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Lyon, France.
J Neurosurg Spine. 2006 Nov;5(5):471-5. doi: 10.3171/spi.2006.5.5.471.
The authors describe a precise surgical technique in which a large intraspinal and extraspinal, multivertebral, cervical chordoma was completely removed in one stage using the lateral approach. The patient in this case was a 29-year-old woman who presented with signs of radicular pain in the left C-3 area. Computed tomography and magnetic resonance imaging demonstrated a large intra- and extraspinal multivertebral tumor from C-2 to C-5, a finding that suggested a cervical chordoma. The tumor was completely removed in one stage using the lateral approach while controlling the vertebral artery (VA), and a partial corporectomy of C2-5 was also performed. Results from a postoperative histopathological examination confirmed that the tumor was a typical chordoma. The patient's postoperative course was uneventful. Cervical chordomas are typically excised using a posterior-anterior surgical approach with partial resection of the tumor. The lateral approach was appropriate in this patient for complete resection in one stage, because it enabled the surgeons to control the VA and access both extraspinal and intraspinal components of the chordoma.
作者描述了一种精确的手术技术,即采用外侧入路一期完全切除一例大型椎管内外多节段颈椎脊索瘤。该病例患者为一名29岁女性,表现为左侧C-3区域神经根性疼痛症状。计算机断层扫描和磁共振成像显示从C-2至C-5有一个大型椎管内外多节段肿瘤,这一发现提示为颈椎脊索瘤。采用外侧入路在控制椎动脉(VA)的同时一期完全切除肿瘤,并对C2-5进行了部分椎体切除术。术后组织病理学检查结果证实该肿瘤为典型的脊索瘤。患者术后恢复顺利。颈椎脊索瘤通常采用前后联合手术入路并部分切除肿瘤。外侧入路对该患者一期完全切除肿瘤是合适的,因为它使外科医生能够控制椎动脉并处理脊索瘤的椎管外和椎管内部分。