Metastasis development at the site of cervical spine arthrodesis.
Biologically, the site of arthrodesis provides a microenvironment replete of growth factors and active remodeling, which is propitious for bone regrowth. There is a theoretical possibility though that this microenvironment would also provide a fertile site for metastatic deposits to occur. Although spinal fusion with various types of instrumentation is commonly used to treat various disorders, development of tumors at the site of spinal arthrodesis has not been previously reported. We present the clinical, radiographic, and pathological features of a case of previously undiagnosed metastatic adenocarcinoma, occurring 1 year following anterior arthrodesis and fusion for cervical spondylotic myelopathy at the C3-C4 level. The patient's initial radiologic presentation suggested an epidural abscess with osteomyelitic destruction of C3 and C4. Our report alerts surgeons to the possibility that metastasis may occur at the site of a previous spinal arthrodesis.
Pillai
Promod
P
Department of Neurological Surgery and Pathology, The Ohio State University Medical Center, Columbus, OH, USA. promod.pillai@osumc.edu
Mendel
Ehud
E
Ray-Chaudhury
Abhik
A
Slone
Wayne
W
Ammirati
Mario
M
Chiocca
Antonio E
AE
D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D001174:Arthrodesis / Q000009:adverse effects*; D001861:Bone Regeneration / Q000502:physiology; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002633:Chemotaxis / Q000502:physiology; D019299:Decompression, Surgical; D018450:Disease Progression; D017586:Diskectomy / Q000009:adverse effects; D017809:Fatal Outcome; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control; D019635:Neurosurgical Procedures; D010012:Osteogenesis / Q000502:physiology; D011859:Radiography; D012086:Reoperation; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods; D013125:Spinal Neoplasms / Q000556:secondary* / Q000601:surgery; D013130:Spinal Stenosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D055009:Spondylosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
D036341:Intercellular Signaling Peptides and Proteins