One-stage posterior resection is feasible for a holovertebral aneurysmal bone cyst of the axis: a case report and literature review.
BACKGROUND
For cervical spine ABC, staged surgery and the combination of both anterior and posterior approaches are usually necessary for lesions involving all 3 (anterior, middle, and posterior) columns of the spine (holovertebral).


METHODS
A 20-year-old young man presented with quadriplegia and acute urine retention lasting for 3 days in November 2006. The diagnosis of an ABC involving the C2 vertebral body, pedicles, laminae, and spinous process was made by MRI. One-stage surgery with intralesional injection of fibrin glue via the posterior approach only was able to deliver complete resection and spinal stabilization. His neurologic function recovered well, and he was able to walk independently 10 days postoperation. At the 1-year follow-up, image studies of the cervical spine demonstrated good bone fusion without recurrence of ABC. The C2 vertebral body also showed resolution of ABC and good trabeculation.


CONCLUSIONS
Intralesional injection of fibrin glue during the operation for holovertebral ABC can be beneficial to (1) avoid using an anterior approach for complete resection and reconstruction, which was usually required in previous reports, and (2) effectively decrease the blood loss during surgery.
Fay
Li-Yu
LY
Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Wu
Jau-Ching
JC
Huang
Wen-Cheng
WC
Shih
Yang-Hsin
YH
Cheng
Henrich
H
D001368:Axis, Cervical Vertebra / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D017824:Bone Cysts, Aneurysmal / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006801:Humans; D016268:Internal Fixators; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D011300:Preoperative Care; D011782:Quadriplegia / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000379:methods; D013115:Spinal Canal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013116:Spinal Cord / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013117:Spinal Cord Compression / Q000209:etiology / Q000473:pathology / Q000601:surgery; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000209:etiology; D055815:Young Adult
D015718:Fibrin Tissue Adhesive