Wewel Joshua T, Nunna Ravi S, Tan Lee A, Kasliwal Manish K, O'Toole John E
Department of Neurosurgery, Rush University Medical Center, Rush Professional Office Building, 1725 W. Harrison Street, Suite 855, Chicago, IL 60612, USA.
Department of Neurosurgery, Rush University Medical Center, Rush Professional Office Building, 1725 W. Harrison Street, Suite 855, Chicago, IL 60612, USA.
J Clin Neurosci. 2016 Aug;30:157-160. doi: 10.1016/j.jocn.2016.02.004. Epub 2016 Mar 10.
Chordoma is a locally aggressive malignant tumor that generally occurs in the clivus, mobile spine and sacrum. While en bloc resection with wide margins has been advocated as the only cure for chordomas, tumor characteristics and violation of critical anatomical boundaries may preclude pursuing this treatment option in the cervical spine. We present a C2 chordoma in a 35-year-old man with epidural and prevertebral extension that was treated with a single stage anterior-posterior total C2 spondylectomy with novel reconstruction using an expandable cage with integrated fixation followed by stereotactic radiosurgery. Single stage intralesional total C2 spondylectomy via anterior transoral and posterior approaches was performed. The anterior column was reconstructed using an expandable cage with integrated fixation from the clivus to C3. The patient maintained his intact neurological status at 6 month follow-up with full resumption of activities of daily living without any significant morbidity.
脊索瘤是一种具有局部侵袭性的恶性肿瘤，通常发生于斜坡、活动脊柱和骶骨。虽然整块切除并保证切缘阴性一直被视为治疗脊索瘤的唯一根治方法，但肿瘤的特征以及关键解剖边界的侵犯可能使颈椎无法采用这种治疗方案。我们报告一例35岁男性C2脊索瘤，肿瘤累及硬膜外和椎体前方，采用一期前后路联合C2全椎体切除术，使用带有一体化固定装置的可扩张椎间融合器进行新型重建，随后进行立体定向放射外科治疗。通过经口前路和后路进行一期瘤内C2全椎体切除术。使用从斜坡至C3带有一体化固定装置的可扩张椎间融合器重建前柱。患者在6个月随访时神经功能完好，日常生活活动完全恢复，无任何严重并发症。
