Marginal En Bloc Resection of C2–C3 Chordoma with Bilateral Vertebral Artery Preservation and Mesh Cage Reconstruction with Review of Previously Published Cases

Tenny, Steven; Ehlers, Landon D.; Robbins, Johanna; Gillis, Christopher C.

doi:10.1016/j.wneu.2017.08.178

Cited by 11 publications

(5 citation statements)

References 38 publications

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“…Our modified anterior fixation system provided an excellent level of stability comparable with that achieved with the fixation techniques described by Tenny et al . [ 11 ] and Weil and colleagues [ 12 ]. The presence of rigid spinal fusion and the absence of implant loosening at the midterm follow-up confirmed the success of our approach.…”

Section: Discussionmentioning

confidence: 99%

“…[ 13 ] 2016 35/M Transoral and posterior approach Expandable cage 6 months Intact neurological status without any significant morbidity Tenny et al . [ 11 ] 2017 55/F Anterior transmandibular and posterior approach Pyrimesh cage 10 months Tumor free Petrov et al . [ 8 ] 2019 27/M Transoral robotic surgery with a posterior approach Iliac crest bone graft 15 months Disease free The present study 47/F Transoral transmandibular and posterior approach Titanium mesh cage 5 years No recurrence without neurological deficit …”

Section: Introductionmentioning

confidence: 99%

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Midterm outcome after en bloc resection of C2 chordoma with transoral mandibular split and mesh cage reconstruction: a case report

et al. 2023

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Introduction Chordomas are rare, locally aggressive tumors that often occur in the axial spine, especially in the sacrum. The treatment of chordomas located in the upper cervical spine is challenging. En bloc resection is the preferred surgical option for total tumor removal. Case presentation We report the case of a C2 chordoma in a 47-year-old Thai woman. She was treated with a two-stage, anterior–posterior, C2 total spondylectomy with titanium mesh cage reconstruction and radiotherapy. The first stage involved posterior stabilization from the occiput to C5, a total laminectomy, and removal of the posterior rings of the bilateral foramen transversarium to preserve the bilateral vertebral arteries. The second stage comprised a transoral mandibular split with en bloc resection of C2, followed by titanium mesh cage reconstruction and kick-off anterior cervical plating. At the 5 year follow-up, no tumor recurrence was identified on magnetic resonance imaging. The patient had no neurological deficits but still had minor complications from the anterior transoral mandibular split. Conclusions Excellent midterm results were obtained using a transoral mandibular split with reconstruction and posterior spinal fusion from the occiput to the lower cervical spine coupled with adjuvant radiotherapy. We recommend this approach as the treatment of choice for chordoma in the upper cervical spine.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Midterm outcome after en bloc resection of C2 chordoma with transoral mandibular split and mesh cage reconstruction: a case report

et al. 2023

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“…Chordomas are malignant tumors originating from embryonic remnants of the notochord, as identified by pathologists [1] . These tumors are most commonly found in the axial skeleton [2] .…”

Section: Introductionmentioning

confidence: 99%

Parasagittal resection of multilevel cervical chordoma with autograft duraplasty and unilateral vertebral artery ligation: A case report and literature review

Tavares Junior,

Morale,

Soares

et al. 2024

Radiology Case Reports

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“…1 They are thought to arise from transformed remnants of the notochord that may have persisted along the spinal axis from the clivus to the sacrum. [1][2][3] Accounting for approximately 1%-4% of all malignant bone tumors, chordomas have an estimated incidence of 1 in 1,000,000 individuals in the general population. 2,4 Although slow-growing and histologically low grade, chordomas can be locally invasive and difficult to treat because of their location near vital neurovascular structures in the brain and spine.…”

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confidence: 99%

“…[1][2][3] Accounting for approximately 1%-4% of all malignant bone tumors, chordomas have an estimated incidence of 1 in 1,000,000 individuals in the general population. 2,4 Although slow-growing and histologically low grade, chordomas can be locally invasive and difficult to treat because of their location near vital neurovascular structures in the brain and spine. In many cases, treatment for chordomas involves a combination of surgery and adjuvant therapy, including radiotherapy.…”

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confidence: 99%

Quality of life in chordoma survivors: results from the Chordoma Foundation Survivorship Survey

Jimenez,

Cicalese,

Jimenez

et al. 2024

Neurosurgical Focus

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OBJECTIVE Chordomas are rare malignant bone tumors whose location in the skull base or spine, invasive surgical treatment, and accompanying adjuvant radiotherapy may all lead patients to experience poor quality of life (QOL). Limited research has been conducted on specific demographic and clinical factors associated with decreased QOL in chordoma survivors. Thus, the aim of the present study was to investigate several potential variables and their impact on specific QOL domains in these patients as well the frequencies of specific QOL challenges within these domains. METHODS The Chordoma Foundation (CF) Survivorship Survey was electronically distributed to chordoma survivors subscribed to the CF Chordoma Connections forum. Survey questions assessed QOL in three domains: physical, emotional/cognitive, and social. The degree of impairment was assessed by grouping the participants into high- and low-challenge groups designated by having ≥ 5 or < 5 symptoms or challenges within a given QOL domain. Bivariate analysis of demographic and clinical characteristics between these groups was conducted using Fisher’s exact test and the Mann-Whitney U-test. RESULTS A total of 665 chordoma survivors at least partially completed the survey. On bivariate analysis, female sex was significantly associated with increased odds of significant emotional (p = 0.001) and social (p = 0.019) QOL burden. Younger survivors (age < 65 years) were significantly more likely to experience significant physical (p < 0.0001), emotional (p < 0.0001), and social (p < 0.0001) QOL burden. Skull base chordoma survivors had significantly higher emotional/cognitive QOL burden than spinal chordoma survivors (p = 0.022), while the converse was true for social QOL challenges (p = 0.0048). Survivors currently in treatment were significantly more likely to experience significant physical QOL challenges compared with survivors who completed their treatment > 10 years ago (p = 0.0074). Fear of cancer recurrence (FCR) was the most commonly reported emotional/cognitive QOL challenge (49.6%). Only 41% of the participants reported having their needs met for their physical QOL challenges as well as 25% for emotional/cognitive and 18% for social. CONCLUSIONS The authors’ findings suggest that younger survivors, female survivors, and survivors currently undergoing treatment for chordoma are at high risk for adverse QOL outcomes. Additionally, although nearly half of the participants reported a FCR, very few reported having adequate emotional/cognitive care. These findings may be useful in identifying specific groups of chordoma survivors vulnerable to QOL challenges and bring to light the need to expand care to meet the QOL needs for these patients.

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Marginal En Bloc Resection of C2–C3 Chordoma with Bilateral Vertebral Artery Preservation and Mesh Cage Reconstruction with Review of Previously Published Cases

Cited by 11 publications

References 38 publications

Midterm outcome after en bloc resection of C2 chordoma with transoral mandibular split and mesh cage reconstruction: a case report

Midterm outcome after en bloc resection of C2 chordoma with transoral mandibular split and mesh cage reconstruction: a case report

Parasagittal resection of multilevel cervical chordoma with autograft duraplasty and unilateral vertebral artery ligation: A case report and literature review

Quality of life in chordoma survivors: results from the Chordoma Foundation Survivorship Survey

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