Single-stage total C-2 intralesional spondylectomy for chordoma with three-column reconstruction. Technical note

• Published in: Journal of neurosurgery. Spine Vol. 6; no. 6; p. 611
• Main Authors: Suchomel, Petr, Buchvald, Pavel, Barsa, Pavel, Froehlich, Robert, Choutka, Ondrej, Krejzar, Zdenek, Sourkova, Petra, Endrych, Ladislav, Dzan, Ladislav
• Format: Journal Article
• Language: English
• Published: United States 01.06.2007
• Subjects: Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - pathology; Cervical Vertebrae - surgery; Chordoma - diagnosis; Chordoma - physiopathology; Chordoma - surgery; Humans; Image Processing, Computer-Assisted; Internal Fixators; Magnetic Resonance Imaging; Male; Middle Aged; Neurosurgical Procedures - methods; Spinal Neoplasms - diagnosis; Spinal Neoplasms - physiopathology; Spinal Neoplasms - surgery; Tomography, X-Ray Computed; Vertebral Artery - physiopathology
• ISSN: 1547-5654
• DOI: 10.3171/spi.2007.6.6.17

Chordomas are locally invasive, malignant bone tumors that rarely occur in the cervical spine. En bloc resection or even fully resecting the tumor along its margin offers improved patient survival and a potential disease cure. Complete resection of tumors involving the upper cervical vertebrae requires a combined anterior-posterior approach but is complicated by the presence of vertebral arteries (VAs). In addition, reconstruction of the postresection defect may be prone to failure. The authors present a case of a chordoma involving the axis that was treated using a single-stage total intralesional C-2 spondylectomy with preservation of both VAs because the patient did not tolerate a preoperative occlusion test. A three-column reconstruction technique is also presented.