Open biopsy with posterior instrumentation followed by anterolateral approach for removal of an uncommon tumor in the cervical spine

Abstract Background The purpose of this study was to evaluate the efficacy and safety of structural manubrium autografts in the surgical treatment of cervical spinal tuberculosis.Methods From January 2015 and December 2018, 10 patients with lower cervical spine tuberculosis (C4-C7) underwent anterior debridement, interbody fusion with structural manubrium autograft, and anterior or posterior instrumentation. The medical records and radiographic findings of the patients were reviewed.Results The surgery duration was 198.5 min and blood loss was 355.0 mL. The average preoperative kyphosis angle was 16.3 ± 8.2° and returned to -2.1 ± 2.8° two weeks postoperatively (P < 0.05 ), reaching -1.4 ± 2.5° at final follow-up (P < 0.05 vs. preoperative). The average preoperative visual analog scale score of neck pain was 4.1 ± 1.1, which decreased to 1.5 ± 0.8 one week after the surgery (P < 0.05 ) and to 0.7 ± 0.5 at final follow-up. The ESR and CRP gradually decreased postoperatively, becoming normal at final follow-up. Bony fusion was achieved in all patients by 6 months after surgery. Neurological outcomes were improved by 1–2 grades in most patients. There were no postoperative complications associated with the donor site, and there was no recurrence of tuberculosis in any patient.Conclusion Structural bone obtained from the manubrium is safe, providing a viable alternative to cervical fusion for patients with cervical spine tuberculosis. It confers the advantages of autograft fusion without the complications associated with donor site morbidities.

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Dysphagia caused by Anterior Cervical Osteophyte: A Rare Entity Revisited

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1121 ◽

2012 ◽

Vol 3 (3) ◽

pp. 168-171

Author(s):

Prashanth Veerabhadraiah ◽

Vishal Rao ◽

Raghavendra Shankar ◽

Naveen Shivappa ◽

TM Nagaraj

Keyword(s):

Case Report ◽

Cervical Spine ◽

Cervical Spondylosis ◽

Diffuse Idiopathic Skeletal Hyperostosis ◽

Anterolateral Approach ◽

Rare Entity ◽

External Compression ◽

Radiographic Findings ◽

Cervical Osteophytes ◽

Life Threatening

ABSTRACT Large anterior cervical osteophytes can occur in degeneration of the cervical spine, cervical spondylosis or in diffuse idiopathic skeletal hyperostosis (DISH). Voluminous anterior cervical osteophytes which can develop from C3 to C7 can cause narrowing of the pharyngoesophageal segment by external compression and may cause dysphagia, which may be life threatening when it is associated with aspiration and or dyspnea. The objective of this case report is to highlight how commonly occurring anterior cervical osteophytes may become an unrecognized cause for life-threatening dysphagia. The clinical and radiographic findings in patient with dysphagia and ventral osteophytes of the cervical spine due to degeneration are demonstrated. The anterolateral approach for removal of these osteophytes is described. How to cite this article Veerabhadraiah P, Rao V, Shankar R, Shivappa N, Kumar P, Nagaraj TM. Dysphagia caused by Anterior Cervical Osteophyte: A Rare Entity Revisited. Int J Head and Neck Surg 2012;3(3):168-171.

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Computer-assisted surgery in posterior instrumentation of the cervical spine: an in-vitro feasibility study

European Spine Journal ◽

10.1007/pl00010024 ◽

2000 ◽

Vol 9 (S1) ◽

pp. S065-S070 ◽

Cited By ~ 61

Author(s):

M. Richter ◽

L.-P. Amiot ◽

S. Neller ◽

P. Kluger ◽

W. Puhl

Keyword(s):

Cervical Spine ◽

Feasibility Study ◽

Posterior Instrumentation ◽

Computer Assisted Surgery ◽

Computer Assisted

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The Axis Fixation System for Posterior Instrumentation of the Cervical Spine

Neurosurgery ◽

10.1227/00006123-199609000-00039 ◽

1996 ◽

Vol 39 (3) ◽

pp. 612-614 ◽

Cited By ~ 1

Author(s):

Paul R. Cooper

Keyword(s):

Cervical Spine ◽

Posterior Instrumentation ◽

Axis Fixation ◽

Fixation System

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Long-term follow up of surgical outcomes in patients with cervical disorders undergoing hemodialysis

Journal of Neurosurgery Spine ◽

10.3171/spi.2006.5.4.313 ◽

2006 ◽

Vol 5 (4) ◽

pp. 313-319 ◽

Cited By ~ 35

Author(s):

Hideki Sudo ◽

Manabu Ito ◽

Kuniyoshi Abumi ◽

Yoshihisa Kotani ◽

Tatsuto Takeuchi ◽

...

Keyword(s):

Cervical Spine ◽

Spinal Fusion ◽

Posterior Instrumentation ◽

Survival Rates ◽

Spinal Instability ◽

Initial Surgery ◽

Long Term Follow Up ◽

Spine Disorders

Object As increasing numbers of patients receive long-term hemodialysis, the number of reports regarding hemodialysis-related cervical spine disorders has also increased. However, there have been few reports summarizing the surgical results in patients with these disorders. The objective of this study was to evaluate the long-term follow up and clinical results after surgical treatment of cervical disorders in patients undergoing hemodialysis. Methods Seventeen patients in whom surgery was performed for cervical spine disorders while they received long-term hemodialysis therapy were enrolled in this study. Of these, 15 underwent follow-up review for more than 3 years after surgery, and these represent the study population. The remaining two patients died of postoperative sepsis. The average follow-up period was 120 months. Five patients without spinal instability underwent spinal cord decompression in which bilateral open-door laminoplasty was performed. Ten patients with destructive spondyloarthropathy (DSA) underwent reconstructive surgery involving pedicle screw (PS) fixation. In eight patients in whom posterior instrumentation was placed, anterior strut bone grafting was performed with autologous iliac bone to treat anterior-column destruction. Marked neurological recovery was obtained in all patients after the initial surgery. In the mobile segments adjacent to the site of previous spinal fusion, the authors observed progressive destructive changes with significant instability in four patients (40%) who underwent circumferential spinal fusion. No patients required a second surgery after laminoplasty for spinal canal stenosis without DSA changes. Conclusions Cervical PS-assisted reconstruction provided an excellent fusion rate and good spinal alignment. During the long-term follow-up period, however, some cases required extension of the spinal fusion due to the destructive changes in the adjacent vertebral levels. Guidelines or recommendations to overcome these problems should be produced to further increase the survival rates of patients undergoing hemodialysis.

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One-stage surgical management for tuberculosis of the upper cervical spine by posterior debridement, short-segment fusion, and posterior instrumentation in children

European Spine Journal ◽

10.1007/s00586-012-2544-0 ◽

2012 ◽

Vol 22 (1) ◽

pp. 72-78 ◽

Cited By ~ 8

Author(s):

Hong-qi Zhang ◽

Min-zhong Lin ◽

Hu-Bing Guo ◽

Lei Ge ◽

Jian-huang Wu ◽

...

Keyword(s):

Cervical Spine ◽

Surgical Management ◽

Posterior Instrumentation ◽

Upper Cervical Spine ◽

Short Segment ◽

One Stage ◽

Upper Cervical ◽

Posterior Debridement

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Cervical spinal metastasis: anterior reconstruction and stabilization techniques after tumor resection

Neurosurgical FOCUS ◽

10.3171/foc.2003.15.5.2 ◽

2003 ◽

Vol 15 (5) ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

James K. Liu ◽

Ronald I. Apfelbaum ◽

Bennie W. Chiles ◽

Meic H. Schmidt

Keyword(s):

Cervical Spine ◽

Spinal Metastasis ◽

Posterior Instrumentation ◽

Tumor Resection ◽

Spinal Metastases ◽

Metastatic Tumor ◽

Subaxial Cervical Spine ◽

Bone Autograft ◽

Anterior Reconstruction ◽

Anterior Cervical Corpectomy

Object In a review of the literature, the authors provide an overview of various techniques that have evolved for reconstruction and stabilization after resection for metastatic disease in the subaxial cervical spine. Methods Reconstruction and stabilization of the cervical spine after vertebral body (VB) resection for metastatic tumor is an important goal in the surgical management of spinal metastasis. Generally, the VB defect is reconstructed with bone autograft or allograft, polymethylmethacrylate (PMMA), interbody spacers, and/or cages. In cases of PMMA-assisted reconstruction, internal devices are used to augment the fixation of PMMA. Stabilization is then achieved with anterior instrumentation, usually an anterior cervical locking plate. In some cases, posterior instrumentation may be necessary to supplement the anterior construct. Conclusions Anterior cervical corpectomy followed by reconstruction and stabilization is an effective strategy in the management of spinal metastases in patients.

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