Tenny Steven O, Ehlers Landon D, Robbins J Will, Gillis Christopher C
Department of Surgery, Division of Neurosurgery, Nebraska Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Department of Surgery, Division of Neurosurgery, Nebraska Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
World Neurosurg. 2017 Dec;108:993.e1-993.e7. doi: 10.1016/j.wneu.2017.08.178. Epub 2017 Sep 6.
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.
脊索瘤起源于脊索残余组织，可发生于整个神经轴。由于上颈椎独特的结构解剖以及与椎动脉和脊髓的紧密关系，整块切除脊索瘤在该部位极具挑战性。
我们描述了一名55岁女性C2 - C3脊索瘤的两阶段切除手术，术中保留了椎动脉。首先，进行后路器械辅助融合并切除后部结构，随后通过下颌前入路整块切除肿瘤，并使用市售产品进行带踢板支撑的椎间融合器重建。
上颈椎脊索瘤手术具有挑战性，但可进行整块切除。通过精心规划和术中灵活应变，外科医生可以使用市售产品实现合适的重建。
