En bloc resection of multilevel cervical chordoma with C-2 involvement. Case report and description of operative technique.
Chordomas are locally aggressive neoplasms with an extremely high propensity to recur locally following resection, despite adjuvant therapy. This biological behavior has led most authors to conclude that en bloc resection provides the best chance for the patient's prolonged disease-free survival and possible cure. The authors present a case of an extensive upper cervical chordoma treated by en bloc resection, reconstruction, and long-segment stabilization. Total spondylectomy of C2-4 with sacrifice of the right C2-4 nerve roots and a segment of the right vertebral artery was performed. The inherent anatomical complexities of en bloc resection in the upper cervical spine are discussed. To the authors' knowledge, this represents the first report of an en bloc resection for multi-level cervical chordoma.
Rhines
Laurence D
LD
Department of Neurosurgery, The University of Texas M D Anderson Cancer Center, Houston, Texas 77030, USA. lrhines@mdanderson.org
Fourney
Daryl R
DR
Siadati
Abdolreza
A
Suk
Ian
I
Gokaslan
Ziya L
ZL
D001863:Bone Screws; D016025:Bone Transplantation; D001864:Bone Wires; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D002817:Chordoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D017586:Diskectomy; D005500:Follow-Up Studies; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008866:Microsurgery; D009777:Occipital Bone / Q000473:pathology / Q000601:surgery; D009809:Odontoid Process / Q000473:pathology / Q000601:surgery; D010614:Pharynx / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D012086:Reoperation; D013123:Spinal Fusion; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D013126:Spinal Nerve Roots / Q000473:pathology / Q000601:surgery; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed