Total En Bloc Spondylectomy of C3: A New Surgical Technique and Literature Review.

摘要: Purpose of the study Radical resection a vertebra is reserved only for specific tumors that invade surrounding tissues and recur when not removed completely. The may be using piecemeal technique or en bloc, two (in thoracolumbar spine) more osteotomies cervical spine). We present our bloc subaxial Ewing's sarcoma C3, with preservation all nerve roots both vertebral arteries. To knowledge, this surgical has been reported in English literature. aim to describe new radical vertebra. Material methods A transoral biopsy tumor tissue anterior C2-C3 was performed 8-year old boy, revealing diagnosis sarcoma. patient started on neoadjuvant chemotherapy. After 6 chemotherapy cycles VIDE regimen, soft-tissue component completely regressed, residual deposit C3 body. Based further multidisciplinary meeting, an spondylectomy recommended, preferably In August 2014, prior planned surgery, we another thorough examination plain films, CT MRI. Neither angiography nor embolization performed. DESCRIPTION OF SURGICAL TECHNIQUE: first stage operation consisted posterior structures. exposed elements C2 C4 by mid-line incision. arch without pathological changes. partial inferior superior articular processes bilateral osteotomy region pedicle adjacent chisel whole arch. Subsequently perforated transverse foramina close pedicle, fine Kerrison rongeurs. lateral parts around arteries were left situ. next step used instrumentation polyaxial screws stabilize C2-C4 section. 19 days second surgery from approach removal made incision sternocleidomastoid between internal carotid artery trachea right side at level expose spine. resected C3-C4 intervertebral discs then rongeurs sides, again, Subsequently, body released extracted bloc. step, mobilized shifted medially portions empty space filled solid allograft levels bridged plate 2+1+2 configuration. Results There no complications during surgeries. follow-up 4 months after revealed clear bone fusion C2-C4, anteriorly bodies posteriorly arches. Clinically reached 8 month follow up had complaints, he his parents satisfied. Physiotherapy proceeding according plan. remains under supervision centre. Discussion Total neural vascular structures described literature once. 2007 published total C5 chordoma, preserving above mentioned Authors lamina osteotomy. Transverse Gigli saw fashion, including tubercle. they tubercle approach. However, their treatment differs here does correspond fully principle resection. Our based similar performing several use high speed burr, while difference can particularly seen remove foramen, which are consider it as ideal split smooth cuts into four them Conclusion should treat most serious conditions. risk neurological deficit outweighed benefits oncological radicality. This yet clear, larger cohort patients necessary assess potentially modify so frequently future.