Department of Neurosurgery, The Kaiser Permanente Medical Group, Sacramento, California, USA.
J Neurosurg Spine. 2013 Aug;19(2):232-42. doi: 10.3171/2013.5.SPINE121039. Epub 2013 Jun 14.
En bloc resection of cervical chordomas has led to longer survival rates but has resulted in significant morbidities from the procedure, especially when the tumor is multilevel and located in the high-cervical (C1-3) region. To date, there have been only 5 reported cases of multilevel en bloc resection of chordomas in the high-cervical spine. In this technical report the authors describe a sixth case. A complete spondylectomy was performed at C-2 and C-3 with spinal reconstruction and stabilization, using several new modalities that were not used in the previous cases. The use of 1) preoperative endovascular sacrificing of the vertebral artery, 2) CT image-guidance, 3) an ultrasonic aspirator for skeletonizing the vertebral artery, and 4) the custom design of an anterior cage all contributed to absence of intraoperative or long-term (20 months) hardware failure and pseudarthrosis.
整块切除术治疗颈椎脊索瘤可提高生存率，但会导致严重的手术并发症，特别是肿瘤为多节段且位于高位颈椎（C1-3）时。迄今为止，仅有 5 例高位颈椎多节段脊索瘤整块切除术的报道。在本技术报告中，作者描述了第 6 例病例。采用多种新方法在 C2 和 C3 行全脊椎切除术，进行脊柱重建和固定，这些方法在之前的病例中并未使用。术前血管内椎动脉结扎、CT 图像引导、超声吸引器用于椎动脉硬化骨骼化以及定制设计的前路 cage 的使用均有助于避免术中或长期（20 个月）内固定失败和假关节形成。
