title: Anterior Reconstruction of C2-C3 Bodies in a 6-Year-Old Patient with a Huge Osteoblastoma: A Novel Technique.
abstract: Study Design Case report. Objective We report the youngest child diagnosed with upper cervical osteoblastoma and the first case operated on with our novel surgical approach. Methods Our patient underwent a two-stage surgery. During the first operation via a posterior approach, a subtotal resection of a C2 bony mass was performed. C3 was also subtotally resected due to tumor extension. Posterior fixation of C1-C5 was performed by C1 sublaminar hooks and C4 and C5 lateral mass screws. Ten days later, a total resection of the residual bony mass was performed through an anterior approach (between the sternocleidomastoid muscle and carotid sheath). Reconstruction of C1-C3 was performed with C1 anterior sublaminar wiring and an expandable titanium cage. Results Successful reconstruction of C2-C3 vertebral bodies was achieved. At 2-year follow-up, the child was symptom-free. Imaging studies revealed no recurrence of tumor or instability. Conclusion A novel technique for reconstruction of C2-C3 vertebral bodies is demonstrated for the youngest case (a 6-year-old boy) of osteoblastoma in the literature. We recommend this approach for cervical spine reconstruction in patients who have an intact C1 arc and resected lower bodies.
authors.affiliation: Department of Neurosurgery, Neurospine Section, Chamran Hospital, Shiraz University of Medical Sciences (SUMS), Shiraz, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Haghnegahdar
authors.affiliation: Department of Neurosurgery, Neurospine Section, Chamran Hospital, Shiraz University of Medical Sciences (SUMS), Shiraz, Iran.
authors.forename: Mahsa
authors.initials: M
authors.lastname: Sedighi
keywords: anterior C1 sublaminar wiring; cervical; osteoblastoma; pediatric spine
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