En bloc resection of a multilevel high-cervical chordoma involving C-2: new operative modalities
Journal of Neurosurgery: Journal of Neurosurgery: Spine: Table of Contents
Journal of Neurosurgery: Spine, Volume 19, Issue 2, Page 232-242, August 2013.
En bloc resection of cervical chordomas has led to longer survival rates but has resulted in significant morbidities from the procedure, especially when the tumor is multilevel and located in the high-cervical (C1–3) region. To date, there have been only 5 reported cases of multilevel en bloc resection of chordomas in the high-cervical spine. In this technical report the authors describe a sixth case. A complete spondylectomy was performed at C-2 and C-3 with spinal reconstruction and stabilization, using several new modalities that were not used in the previous cases. The use of 1) preoperative endovascular sacrificing of the vertebral artery, 2) CT image-guidance, 3) an ultrasonic aspirator for skeletonizing the vertebral artery, and 4) the custom design of an anterior cage all contributed to absence of intraoperative or long-term (20 months) hardware failure and pseudarthrosis.
Original Article: http://thejns.org/doi/abs/10.3171/2013.5.SPINE121039?ai=rt&mi=0&af=R
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