Ebrahimzadeh Kaveh, Mirahmadi Eraghi Mohammad, Hallajnejad Mohammad, Ansari Mohammad, Hosseini Tavasol Hesameddin, Mousavinejad Seyed Ali, Samadian Mohammad
Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Ann Med Surg (Lond). 2024 Dec 12;87(7):4507-4518. doi: 10.1097/MS9.0000000000002785. eCollection 2025 Jul.
There are limited reports of C1 lateral mass reconstruction using a titanium mesh cage following the surgical removal of an aneurysmal bone cyst (ABC). We describe two uncommon and challenging cases of C1 ABC, highlighting the obstacles and complexities involved in selecting the appropriate approach for tumor resection, C1 stabilization, and reconstruction.
A 12-year-old boy presented with 3 months of progressive upper cervical and occipital pain with no history of trauma. A heterogeneous lytic lesion with fluid-fluid levels in the right lateral mass of the atlas was detected. A gross total resection(GTR) of the C1 lateral mass ABC was performed through a posterior approach, followed by constructing the C1 lateral mass. : An 11-year-old girl presented with cervical pain for the past 6 months. A cervical computed tomography (CT) scan without contrast revealed a lytic-expansile mass lesion with bony erosion in the right transverse process of the C1 vertebra. A similar surgical plan was tailored for this patient. A follow-up examination at 6 weeks demonstrated complete pain relief, and routine neurologic evaluations were uneventful.
ABCs are uncommon, non-malignant, and highly vascular tumors, accounting for approximately 1% of all bone tumors and 15% of primary spinal tumors. The treatment of choice in this region is total resection, followed by C1 reconstruction.
C1 lateral mass reconstruction using an expandable cage with vertebral artery (VA) preservation is recommended for extensive C1 lateral mass resection due to ABC.
关于在手术切除动脉瘤样骨囊肿（ABC）后使用钛网笼进行C1侧块重建的报道有限。我们描述了两例罕见且具有挑战性的C1 ABC病例，突出了在选择合适的肿瘤切除、C1稳定和重建方法时所涉及的障碍和复杂性。
一名12岁男孩出现3个月进行性上颈部和枕部疼痛，无外伤史。在寰椎右侧块发现一个有液-液平面的不均匀溶骨性病变。通过后路对C1侧块ABC进行了全切除（GTR），随后构建C1侧块。一名11岁女孩在过去6个月出现颈部疼痛。颈椎计算机断层扫描（CT）平扫显示C1椎体右侧横突有一个溶骨性膨胀性肿块病变伴骨质侵蚀。为该患者制定了类似的手术方案。6周后的随访检查显示疼痛完全缓解，常规神经学评估无异常。
ABC是罕见的、非恶性的且血管丰富的肿瘤，约占所有骨肿瘤的1%和原发性脊柱肿瘤的15%。该区域的首选治疗方法是全切除，随后进行C1重建。
对于因ABC导致的广泛C1侧块切除，建议使用可扩张笼进行C1侧块重建并保留椎动脉（VA）。
