Heinrich Christopher, Gospodarev Vadim, Kheradpour Albert, Zuppan Craig, Douglas Clifford C, Minasian Tanya
Loma Linda University School of Medicine, Loma Linda, CA 92354, USA.
Center for Perinatal Biology, Department of Basic Sciences, Loma Linda University, 11234 Anderson Street, Room 2567, Loma Linda, CA 92354, USA.
Brain Sci. 2019 May 8;9(5):105. doi: 10.3390/brainsci9050105.
Primary osseous tumors of the spinal column account for approximately 1% of the total number of spinal tumors found in the pediatric patient population. The authors present a case of a C1 benign giant cell lesion that was incidentally found in a 15-year-old patient. A transoral biopsy was performed followed by treatment with denosumab, with definitive management in the form of transoral tumor resection with subsequent occiput-cervical three posterior instrumented fusion. The patient tolerated all of the procedures well, as there were no post-operative complications, discharged home neurologically intact and was eager to return to school when assessed during a follow-up visit in clinic. Osteolytic lesions affecting the cervical spine are rare in the pediatric population. It is of utmost importance to have sufficient background knowledge in order to formulate a differential diagnosis, as well as an understanding of principles underlying surgical techniques required to prevent occipital-cervical instability in this patient population. The information presented will guide surgical decision-making by identifying the patient population that would benefit from neurosurgical interventions to stabilize the atlantoaxial junction, in the context of rare osteolytic conditions affecting the cervical spine.
脊柱原发性骨肿瘤约占儿科患者群体中发现的脊柱肿瘤总数的1%。作者报告了一例在一名15岁患者中偶然发现的C1良性巨细胞病变病例。进行了经口活检，随后使用地诺单抗治疗，最终治疗方式为经口肿瘤切除并随后进行枕颈三节段后路器械融合。患者对所有手术耐受良好，无术后并发症，出院时神经功能完好，在门诊随访评估时渴望返校。影响颈椎的溶骨性病变在儿科人群中很少见。拥有足够的背景知识以形成鉴别诊断，以及理解预防该患者群体枕颈不稳定所需手术技术的基本原理至关重要。所提供的信息将通过确定在影响颈椎的罕见溶骨性疾病背景下将从神经外科干预中受益以稳定寰枢关节的患者群体来指导手术决策。
