title: An aneurysmal bone cyst in the cervical spine of a 10-year-old girl: a case report.
abstract: METHODS
  An aneurysmal bone cyst in the neural arch of the fourth cervical vertebra of a 10-year-old girl is reported, along with a brief review of the literature on the topic.
  
  
  OBJECTIVE
  To report the presentation and diagnosis of this disorder along with a discussion of the major pitfalls of treatment.
  
  
  BACKGROUND
  An aneurysmal bone cyst occurs commonly in the second decade, with a predilection for the lumbar spine. With occurrence in the neural arch of a cervical vertebra, the potential for instability following surgical excision is high.
  
  
  METHODS
  A 10-year-old white female presented with neck pain of 3 months' duration. Diagnostic imaging revealed an expansile lytic lesion in the spinous process and lamina of the fourth cervical vertebra. Surgical treatment consisted of excisional biopsy and a segmental instrumented posterior fusion from C3-C5. The histopathology was consistent with an aneurysmal bone cyst.
  
  
  RESULTS
  Surgical excision consisting of laminectomy and instrumented segmental fusion provided a good clinical result, and minimized the risk and degree of the 2 most common complications: recurrence of the tumor; and postlaminectomy kyphosis, a frequent occurrence in the pediatric population.
  
  
  CONCLUSIONS
  In pediatric patients who develop a bone tumor of the posterior elements of the cervical spine, careful clinical and radiologic evaluation is necessary to narrow the differential diagnosis. In most cases, a complete excision should be performed if possible. The risk of postlaminectomy kyphosis is high in the pediatric age population. As such, a fusion should be considered whenever a laminectomy is performed in the immature cervical spine. Risk factors for kyphosis include a high cervical level, multiple laminectomy levels, and postoperative irradiation.
authors.affiliation: Connecticut Orthopaedic Specialists and Department of Orthopaedics, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Beiner
authors.forename: Akhilesh
authors.initials: A
authors.lastname: Sastry
authors.forename: Matthew
authors.initials: M
authors.lastname: Berchuck
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Grauer
authors.forename: Brian K
authors.initials: BK
authors.lastname: Kwon
authors.forename: John K
authors.initials: JK
authors.lastname: Ratliff
authors.forename: Gordon H
authors.initials: GH
authors.lastname: Stock
authors.forename: Andrew K
authors.initials: AK
authors.lastname: Brown
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Vaccaro
mesh_terms: D017824:Bone Cysts, Aneurysmal / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D001860:Bone Plates; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002648:Child; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000209:etiology; D007796:Laminectomy / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D013122:Spinal Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion; D014057:Tomography, X-Ray Computed