Surgical treatment of giant cell tumor of the cervicothoracic spine with combined anterior and posterior approaches

Abstract

Generally, giant cell tumors are rare and their localization in the spine is even more so. They are locally aggressive leading to spine instability and neurologic deficits. Radical excision is highly advocated. A role of radiotherapy in these tumors is controversial. We report the case of a giant cell tumor localized in D1 and D2 on a 39-year-old patient, presented with interscapular back pain, paraparesis grade 3/5 and sphincter dysfunction. Thoracic spine computed tomogarphy and magnetic resonance imaging showed a vertebral body tumor in D1 and D2, compressing the spinal cord at the same level. The patient initially underwent decompressive laminectomy of affected levels and stabilized with laminar hooks and rods. Second surgery performed through an anterior approach whereby tumor excision together with corpectomy of D1 and D2 carried out, autograft was placed and plate applied. Three weeks postoperatively, the patient's neurologic deficit recovered fully and back pain subsided.

Circumferential Reconstruction of Subaxial Cervical and Cervicothoracic Spine by Simultaneously Combined Anterior–posterior Approaches in the Sitting Position

“…In addition, if a cervical tumor invades the vertebra body and lamina, in order to achieve radical excision, decompression and reconstruction simultaneously, a combined anterior and posterior operation is recommended rather than a single remedy. Yoshioka and Habibou describe cases of cervicothoracic giant cell tumors treated by total spondylectomy, and they both put forward that a combined anterior–posterior approach is the only way to achieve total radical excision.…”