Stabilization of metastatic lesions affecting the second cervical vertebra

Abstract

Purpose: Metastatic spine disease is an ever-increasing burden on health care systems. Certain levels in the spine confer unique biomechanical characteristics and hence are of interest. Isolated C2 lesions are rare. We aimed to review our results in surgical management of C2 lesions. Materials and Methods: We reviewed all surgical stabilizations of metastatic spine lesions over the preceding 4 years. Six patients with C2 lesions were identified. Of these five underwent surgical stabilization primarily for disease affecting the second cervical vertebra. Case notes and radiology were reviewed to determine presentation, outcomes and complications. Results: Cases were treated primarily by posterior instrumentation from either occiput or C1 to the subaxial cervical spine. The median survivorship after surgery was 283 days. There were no cases of infection, VTE or implant failure. There were no cases of neurologic deterioration with all maintaining Frankel E grading. Conclusion: Metastatic lesions affecting the second cervical vertebra are rare. A variety of stabilization options tailored to the individual lesions, including occipitocervical fixation, in this small series was successful in maintaining stability and resolution of symptoms.

Keywords

• Axis
• metastasis
• instability
• neoplasia