Surgical Approaches for Radical Resection of Cervical Spine Lesions: Analytical Review and Surgical Experience with Correlation to the Vertebral Artery. A Retrospective Study

Mohammed Albarbarawi, Ziad Odat, Suhair Qudsieh, Tareq Qudsieh

Abstract


Objective: The management cervical spine lesions, with spinal cord compression and vertebral artery involvement, are problematic both in terms of obtaining adequate resection and stabilisation and ensuring neurovascular compromise.

Methods: Cervical spine approaches for total resection of the underlying pathology and reconstruction even in a staged operation are still a matter of challenge. Twelve patients with Non traumatic, non spondylotic cervical spine disorders were managed in this study. The cardinal presentation was neck and arm pain with progressive cervical myelopathy. All patients had plain x-rays of cervical spine, cervical spine CT scan MRI. The angiogram was performed to both vertebral arteries when the pathology is in proximity to the vertebral artery. When tumour blush with feeders was evident; endovascular embolisation to minimize intraoperative bleeding was also considered. A single approach or combined anterior and posterior cervical approaches for corpectomy and cage with plate fixation and then posterior fixation for gross total resection of the lesion was considered as indicated.

Results: All cases made a good neurological recovery and had no neural or vascular complication. Two patients had superficial wound infection that recovered well. Three patients died; two of them died of their primary malignancy and one died from pulmonary embolism. On the long term follow up, there was no recurrence of the disease or surgical failure of the instrumentation.

Conclusion: This report documents a safe and reliable way to deal with non spondylotic, non traumatic cervical spine lesions with preservation of the vertebral arteries in a retrospective manner.

Keywords


Cervical Spine, Non Spondylotic, Spine Fixation, Vertebral Artery, Radical Resection

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