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Subject Area

Oncology, Cervical spine

Document Type

Clinical Study

Abstract

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 wereevaluated 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 thesame 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 adjuvanttherapy. (2013ESJ051)

Keywords

cervical spine tumors, spinal neoplasm, cervical fusion

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