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European Spine Journal

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01-07-2016 | Grand Rounds

Cervical subtotal en-bloc spondylectomy of C6 mesenchymal chondrosarcoma

Authors: Chang-Hwa Lee, Woo-Kie Min

Published in: European Spine Journal | Issue 7/2016

Abstract

Introduction

We present a case of C6 mesenchymal chondrosarcoma and discuss safe posterior to anterior approach subtotal en-bloc spondylectomy.

Materials and methods

A 29-year-old male consulted for our department with severe posterior neck pain doing exercise. CT scan demonstrated a primary osteolytic lesion on C6 left transverse foramen and MRI demonstrated the tumor involved C6 vertebra from layers B, C and F sectors 4–6 encasing left vertebral artery. Preoperatively neurointerventional radiology service occluded the left vertebral artery and tumor feeding artery using coil embolization. Posterior approach consist of C5–C7 laminectomy, left sided C6 and C7 nerve root sacrifice, posterior disc removal and release of C5–6–7 and posterior reconstruction. Then, position was changed to supine, and the anterior approach was followed as C5–6, C6–7 discectomy, left vertebral artery ligation and cut, longus coli resection and C6 subtotal spondylectomy with en-bloc resection of mass, mesh cage insertion and C5–C7 anterior plate fixation. During operation, frozen biopsy was performed on 8 areas (longus coli, lateral margin, anteroinferior margin, posterior margin, posterosuperior margin, C5 transverse foramen, posteroinferior margin, inferior margin) after wide resection. Tumor free margin was confirmed.

Results

After operation, he complained of tingling sensation of left thumb and forearm medial side, and elbow extensor motor grade was checked to 4/5 postoperatively. In the followed-up radiograph, the tumor was completely removed, and the instability of joint was not seen. As a result of observing follow-up CT at a year after the surgery, recurrence findings have not been shown up to now, and the progression of neurologic symptoms has not been shown either.

Conclusion

Based on the Grand Round case and relevant literature, we discuss the case of mesenchymal chondrosarcoma occurring from the C6 cervical spine treated with cervical subtotal en-bloc spondylectomy. Successful en-bloc resection of the tumor was achieved using posterior to anterior approach.

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Title: Cervical subtotal en-bloc spondylectomy of C6 mesenchymal chondrosarcoma
Authors: Chang-Hwa Lee
Woo-Kie Min
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 7/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-4297-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cervical subtotal en-bloc spondylectomy of C6 mesenchymal chondrosarcoma

Abstract

Introduction

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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