Surgical Treatment of Cervical Spine Fibrous Dysplasia: Case Report and Literature Review

Abstract

Background: Fibrous dysplasia (FD) is an uncommon benign intramedullary fibro-osseous lesion. Cervical spine compromise is rare with only cases reported. Currently, the natural history of cervical FD is poorly understood, and its treatment remains controversial. Methods: A review of the literature was performed to analyze and discuss the management of cervical FD through a case report and literature review. Results: Cervical FD is a rare benign pathology. Clinical presentation is usually casual or only clinical pain. Computed tomography (CT)-guided percutaneous biopsy is a safe and effective technique for evaluation of spinal lesions; however, the accuracy of the preoperative biopsy findings has been disappointing. Although all treatments are valid, no one has been demonstrated to be better. Our proposed treatment, a corpectomy and fixation with a titanium mesh cage filled with allograft bone and an anterior cervical plate, showed good results. Conclusions: The rarity of cervical FD and the lack of detailed reports with long-term follow-up periods complicate the research on the optimal treatment approach in these cases, but apparently all are valid for pain control. In our case, a corpectomy and fixation with a titanium mesh cage filled with allograft bone and an anterior cervical plate was carried out and showed good results. We submit this surgery option to be considered in these rare type of injuries.

Monostotic fibrous dysplasia at C7 treated with vertebroplasty: a case report and review of the literature

“…There are several challenges in the application of VP for MFD: (1) It is difficult to accurately diagnose the disease preoperatively because there is a lack of characteristic imaging manifestations, and the FD diagnosis depends on pathology results; in addition, CT-guided percutaneous biopsy for the evaluation of spinal lesions has a reported diagnostic accuracy of approximately 90% [36]. However, the positive FD diagnosis rate is low [23, 37]. Because it is impossible to make a clear diagnosis before surgery, other methods may be applied; thus, it is recommended that open biopsy be carried out when vertebral FD is suspected [23, 36].…”