Triple total cervical vertebrectomy for a giant cell tumor: case report.

Abstract

Case report of a triple total cervical vertebrectomy. To describe a new management for cervical tumor. Preoperative planning using arteriography, successive occlusion of both vertebral arteries, and the cervical vertebrectomy are reported. Thoracic or lumbar complete vertebrectomy for primary malignant tumor or metastasis is a well established surgical technique. The presence of the vertebral arteries appears to have prevented the previous use of complete vertebrectomy in the cervical spine. A 25-year-old male patient who had a giant cell tumor in C6 underwent hemi-vertebrectomy. Before this surgical procedure, the ipsilateral vertebral artery was embolized. The tumor recurred locally 18 months later. Using temporary balloon occlusion of the remaining vertebral artery, an abundant collateral circulation from the cervical arteries to the vertebrobasilar territory was shown. Triple total cervical vertebrectomy from C5-C7 was then performed with double stage surgery. At 2-year follow-up, the patient is tumor-free. Complete resection of malignant cervical vertebrae is possible if both vertebral arteries can be successively occluded, permitting complete removal of the transverse processes.