title: Spontaneous oral extrusion of an acrylic vertebral reconstruction 12 years after a vertebrectomy for a Ewing's sarcoma of the cervical spine: a case report.
abstract: BACKGROUND
  Primary Ewing sarcoma of the cervical spine is rare, particularly in children population. The surgical management remains a challenge to associate the best oncological resection and to prevent spinal deformity. The situation is complicated owing to paucity of adapted instrumentation and their possible interactions with the growing bone.
  
  
  METHODS
  We described the case of a young 19-year-old woman admitted for an oral extrusion of a bone polymethyl methacrylate (PMMA) allograft 12 years after a C4 circumferential vertebrectomy for primary Ewing's sarcoma. The vertebral anterior reconstruction was slowly repulsed by the growing spine giving way to an autologous bone without kyphosis deformation.
  
  
  CONCLUSIONS
  Bone reconstruction remains a challenge after extensive oncological resection particularly in cervical spine of children. Anterior and posterior instrumentation must be associated. The growing spine is not a good host for PMMA allograft and autograft seems to be preferred for anterior column fusion. In spite of the good oncological results, the authors raise the long-term issue of PMMA for vertebral reconstruction in young patients. With a long follow-up, they showed that posterior rigid fixation might prevent the cervical kyphosis.
authors.affiliation: Department of neurosurgery, University hospital, 4, rue Larrey, 49933 Angers cedex 9, France. rogatienfaguer@hotmail.fr
authors.forename: R
authors.initials: R
authors.lastname: Faguer
authors.forename: D
authors.initials: D
authors.lastname: Petit
authors.forename: P
authors.initials: P
authors.lastname: Menei
authors.forename: H-D
authors.initials: HD
authors.lastname: Fournier
mesh_terms: D000328:Adult; D001843:Bone Cements / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000628:therapy*; D016025:Bone Transplantation / Q000009:adverse effects; D005260:Female; D006801:Humans; D019904:Polymethyl Methacrylate / Q000009:adverse effects*; D019651:Plastic Surgery Procedures / Q000379:methods; D012512:Sarcoma, Ewing / Q000175:diagnosis / Q000601:surgery*; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate