Egyptian Spine Journal (Jul 2013)

Primary Osseous Tumors of the Subaxial Cervical Spine, Clinical Case Series

  • Mohamed El-Gaidi,
  • Ehab Eissa

DOI
https://doi.org/10.21608/ESJ.2013.3837
Journal volume & issue
Vol. 7, no. 1
pp. 39 – 46

Abstract

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Background Data: Primary osseous tumors of the subaxial cervical spine are rare and can present with different clinical presentations and pathologies. Study Design: Retrospective descriptive clinical case series. Purpose: To assess the prognosis, surgical management, outcome of primary osseous tumors of the subaxial cervical spine Patients and Methods: Eight patients underwent surgical treatment for primary cervical bony tumors at Kasr Al-Aini Medical School, Cairo University, between 2007 and 2012. Mean follow-up was 24.4±6.8 months. Clinical outcome were evaluated neurologically using Frankel grading system, while visual analog scale (VAS) has been used to evaluate neck pain. Results: There was equal sex distribution and the mean age was 38.4±14.9 years (range 17-62 years). Half of patients had benign tumors (2 aneurysmal bone cysts, one hemangioma and one osteoblastoma) while the other 4 patients had malignant tumors (giant cell tumor, chordoma, chondro-sarcoma and plasmacytoma). Neck pain was the constant complaint of all patients. In addition, 5 patients suffered from myelopathy while 2 patients had radiculopathy. Anterior corpectomy and fusion was performed in four cases, while in 2 patients, only posterior approach was adopted. In the other 2 patients, combined anterior and posterior approaches were adopted. Postoperatively, 6 patients had the same preoperative Frankel grade (4 were grade E, 1 was D and 1 was C), while 2 patients improved (25%) (1 improved from D to E and 1 from C to D). The average VAS improved from 5±1.5 (range 3-8) preoperatively to 2.4±1.7 (range 1-5) postoperatively at last follow-up. The 4 patients with benign tumors are doing well (Frankel grade E). In contrast, 3 out of 4 patients with malignant tumors died within 12-16 m later, the survival of malignant tumors is 25% at 3 years. Conclusion: Marginal piecemeal resection and cervical instrumentation and fusion is a safe and effective method in management of benign osseous cervical tumors. However, the results are poor for malignant tumors even with adjuvant therapy. (2013ESJ051)

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