术中导航在动脉瘤样骨囊肿切除术后C1侧块重建中的应用
Use of Intraoperative Navigation for Reconstruction of the C1 Lateral Mass After Resection of Aneurysmal Bone Cyst.
作者信息
Neva Jennifer, Smith Brandon W, Joseph Jacob R, Park Paul
机构信息
Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
出版信息
World Neurosurg. 2017 Jun;102:693.e21-693.e27. doi: 10.1016/j.wneu.2017.04.010. Epub 2017 Apr 11.
BACKGROUND
Aneurysmal bone cysts (ABCs) are rare blood-filled cystic lesions that are found in the long bones and spine. Here, we present a case of an ABC found in the lateral mass and lamina of C1. Lesions in this area provide a surgical challenge because of its difficulty to access as well as its need for reconstruction. We describe a novel use of intraoperative navigation (ION) to assist in the placement of a C1 lateral mass titanium cage.
CASE DESCRIPTION
An 18-year-old female patient presented with headaches and progressive neck pain. Imaging revealed a large cystic lesion involving the C1 lamina and right lateral mass. The patient underwent ION-assisted aggressive intralesional resection of the ABC and reconstruction of the C1 lateral mass with a static titanium cage, supplemented with posterior fusion from the occiput to C3. At 2-year follow-up, there was no evidence of recurrence and the hardware remained intact.
CONCLUSIONS
ION is a useful aid in assessing the extent of tumor resection and performing cage reconstruction of the C1 lateral mass.
背景
骨动脉瘤样囊肿（ABCs）是一种罕见的充满血液的囊性病变，多见于长骨和脊柱。在此，我们报告一例在C1侧块和椎板发现的ABC病例。该区域的病变因其难以暴露以及需要重建，给手术带来了挑战。我们描述了术中导航（ION）的一种新用途，即辅助放置C1侧块钛笼。
病例描述
一名18岁女性患者出现头痛和进行性颈部疼痛。影像学检查发现一个巨大的囊性病变，累及C1椎板和右侧块。患者接受了ION辅助下对ABC进行的积极病损内切除，并使用静态钛笼对C1侧块进行重建，辅以从枕骨到C3的后路融合术。在2年的随访中，没有复发迹象，植入物保持完好。
结论
ION有助于评估肿瘤切除范围，并有助于进行C1侧块的笼状重建。
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