Image-Guided Lateral Mass Osteotomy for En Bloc Resection of Cervical Ewing Sarcoma: A Technical Note

• Published in: World neurosurgery Vol. 104; pp. 628 - 633
• Main Authors: Li, Jia Xi Julian, Phan, Kevin, Tran, Tommy Manh, Mobbs, Ralph J., Stanford, Ralph
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2017
• Subjects: Adult; Cervical arthrodesis; Cervical spine; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - surgery; En bloc resection; Ewing sarcoma; Humans; Magnetic Resonance Imaging; Male; Osteotomy - methods; Positron-Emission Tomography; Sarcoma, Ewing - diagnostic imaging; Sarcoma, Ewing - surgery; Spinal Neoplasms - diagnostic imaging; Spinal Neoplasms - surgery; Spinal surgery; Surgery, Computer-Assisted - methods; Treatment Outcome; En bloc resection; Ewing sarcoma; Cervical arthrodesis; WBB; ACDF; Spinal surgery; Cervical spine; PET
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2017.05.071

En bloc resection of Ewing sarcoma in the cervical spine according to Enneking's principles is technically challenging owing to the proximity of important neurovascular structures, the complex local anatomy, and the biomechanical instability of radical resection. The rarity of Ewing sarcoma and variability of its presentation justifies ongoing exploration and compilation of the surgical nuances and subtleties of en bloc resection in the cervical spine. We present a 34-year-old male with Ewing sarcoma of the neck who underwent successful en bloc resection using a novel technique of splitting the laminae and osteomizing the lateral masses under imaging guidance. This novel and successful approach of en bloc resection in the cervical spine can add to the spinal surgeon's repertoire when dealing with complex cervical tumor masses.