Aneurysmal Bone Cyst of the Second Cervical Vertebrae Causing Multilevel Upper Cervical Instability

Aneurysmal bone cyst (ABC) infrequently occurs within the upper cervical vertebrae. Various therapeutic options have been reported in the literature. We would like to share our experience in managing a case of a 16-year-old girl diagnosed with ABC at the body of axis (C2) vertebra. Serious attention had to be given on the stability of the cervical spine following tumour resection, which can be affected by the mode of treatment chosen. Instability can have a detrimental effect on the cervical spine, in which case may necessitate further surgery. We performed a single-staged intra-lesional curettage via a transoral approach and temporary non-fusion posterior stabilization of C1 lateral mass screw and C2 pedicle screw. The implants were removed after six months once ossification of C2 has taken place to regain full motion of the neck. There was no evidence of recurrence or instability of the cervical spine three years following surgery.

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Resection of an upper cervical aneurysmal bone cyst and spinal reconstruction using a midline mandibular osteotomy in a pediatric patient

Journal of Neurosurgery Pediatrics ◽

10.3171/2014.3.peds13511 ◽

2014 ◽

Vol 13 (6) ◽

pp. 622-625 ◽

Cited By ~ 6

Author(s):

Michael M. McDowell ◽

Simon J. Hanft ◽

Sophie A. Greenberg ◽

Rahmatullah Rahmati ◽

Vincent Carrao ◽

...

Keyword(s):

Cervical Spine ◽

Pediatric Patient ◽

Aneurysmal Bone Cyst ◽

Posterior Instrumentation ◽

Bone Cyst ◽

Neurological Complications ◽

Upper Cervical Spine ◽

Spinal Reconstruction ◽

Upper Cervical ◽

Transmandibular Approach

The authors report on the surgical management of an extensive lesion of the upper cervical spine that required an uncommon transmandibular approach to facilitate exposure, resection, and stabilization in a pediatric patient. A 6-year-old boy with a large aneurysmal bone cyst of the C-2 vertebra presented with progressive weakness and right-sided neck pain. The lesion extended laterally into the soft tissue of the neck, inferiorly to C-4, and posteriorly around the spinal cord. A transmandibular osteotomy was performed to provide adequate exposure for complete resection of the mass and anterior C1–3 instrumentation and fusion. Subsequently, the patient underwent occiput to C-4 posterior instrumentation and fusion. The patient tolerated the operation well and had regained all function at 3 and 11 months' follow-up. No neurological complications or problems of speech, swallowing, or respiration occurred. Even in pediatric patients, the transmandibular approach for the treatment of upper cervical spine lesions is an effective method of maximizing exposure for complex lesions requiring resection and stabilization.

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Vertebrobasilar insufficiency caused by cervical aneurysmal bone cyst – Case report

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0038-1626266 ◽

2014 ◽

Vol 33 (02) ◽

pp. 155-159

Author(s):

Benjamim Pessoa Vale ◽

Eduardo Leitão de Almeida Lima ◽

Ana Clara Mourão Barreto ◽

Luciano Arruda Macedo

Keyword(s):

Spinal Cord ◽

Aneurysmal Bone Cyst ◽

Cervical Vertebrae ◽

Bone Cyst ◽

Clinical Manifestations ◽

Cord Compression ◽

Vertebrobasilar Insufficiency ◽

Level Of Involvement ◽

Aneurysmal Bone Cysts ◽

The Right

Aneurysmal bone cysts (ABC) are benign bone tumors of relatively rare occurrence. Most of the lesions occur at long bones, vertebrae and flat bones. However, the cervical vertebrae involvement is uncommon. Occasionally, the ABCs compress the spinal cord and nerve roots. Depending on the level of involvement and the extent of spinal cord compression, a wide variety of neurological symptoms and signs may be noted later, ranging from mild radiculopathy to complete paraplegia or tetraplegia. A case of aneurysmal bone cyst involving the second and third cervical vertebrae in a 15 years old patient, causing compression of the right vertebral artery and subsequent vertebrobasilar insufficiency is reported. We also discuss the clinical manifestations of the vertebrobasilar insufficiency, of the spinal compression, and the surgery treatment performed in this case.

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