Multilevel oblique corpectomies as an effective surgical option to treat cervical chordoma in a young girl

Abstract

Chordomas are malignant tumors arising from notochordal remnants. They are the most frequent tumors of the spine after plasmacytomas. Only 6% of chordomas are localized to the cervical level. In young patients, chordomas are rare and unpredictable. Despite this, the treatment of choice remains the total resection, as much as possible, followed by proton beam radiation. This case was managed using a precarotid and retrocarotid approach at the same time. The tumor was completely resected with the edges free from disease. The cervical spine was stabilized with an anterior plating C2-C4. Eighteen months after surgery the patient is still free from illness. Multilevel oblique corpectomies are an available and safe option for the treatment of upper cervical chordomas.

Surgery of cervical spine tumors in the close vicinity to the vertebral artery: literature review

“…65 публикаций суммарно включают данные о 101 пациенте (66 мужчинах и 35 женщинах), средний возраст которых на момент операции составил 38,7 года (min 5; max 83). Пациентов детского возраста (до 18 лет) было 21 (20,8 %), представлены они в 14 работах [5][6][7][8][16][17][18][19][20][21][22][23][24][25], в которых наиболее крупные серии составляют 3 ребенка [5][6][7].…”

“…Распространение опухоли экстравертебрально (слой A по WBB) установлено в 66 случаях, интраканально (слой D) -в 58, интрадурально (слой E) -в 3. Представляет интерес указание на вовлечение в опухолевый процесс слоя F (канал позвоночной артерии) лишь в семи случаях [9,11,15,21,37]. Слой F дополнительно выделен для более детального описания распространения опухоли в шейном отделе позвоночника в дополненной классификации WBB [71]; в оригинальной статье Boriani [9,12,14,[35][36][37][38][39][43][44][45][46].…”

Oblique corpectomy in the cervical spine

“…Due to an extensive and medial vertebral bodies resection, authors decided to perform spinal fusion of C4-C7 with right iliac crest graft and titanium plate and five screws were used for stabilization. OC was also performed in 14-year-old girl with cervical chordoma who presented with cervical pain, dysphagia, hyperreflexia and weakness of the four limbs for 8 months [29]. The preoperative MRI showed a lesion of C2-C4 with marked retropharyngeal and epidural space involvement.…”

Endoscopic Transoral Resection of an Axial Chordoma: A Case Report

“…It is slow growing and locally invasive, however, may metastasize to other organs. The current treatment of choice for chordomas of the mobile spine and sacrum is en-bloc excision with wide margins and postoperative external-beam radiation therapy 1 - 3 . Only 6% of chordomas are localized at the cervical spine 3 .…”

“…The current treatment of choice for chordomas of the mobile spine and sacrum is en-bloc excision with wide margins and postoperative external-beam radiation therapy 1 - 3 . Only 6% of chordomas are localized at the cervical spine 3 . The resection of an upper cervical chordoma poses unique challenges to surgeons, hence, making wide resection surgery very challenging.…”