Management of C2 Body Giant Cell Tumor by Innovatively Fashioned Iliac Crest Graft and Modified Cervical Mesh Cage Used as Plate

World Neurosurg. 2020 Aug:140:241-246. doi: 10.1016/j.wneu.2020.05.182. Epub 2020 May 27.

Abstract

Background: Locally aggressive vertebral body tumors of the axis must be treated with wide local excision for best outcome. Reconstruction of the load-bearing vertebra needs to be done after tumor resection in such a manner so as to give stable, long-term fusion in this young population.

Methods: We describe the management strategy of a 25-year-old acutely quadriplegic patient, with respiratory distress, with a C2 giant cell tumor. The use of a novel iliac crest graft modification used for C2 reconstruction along with a modified mesh cage used as an anterior plate has been reported.

Results: The patient had a good outcome at 18 months' follow-up, with neurologic improvement and a solid fusion.

Conclusions: Iliac crest autograft is inexpensive and easy to harvest and can be considered as a C2 prosthesis, especially in a resource-constrained setting. Modified iliac crest graft can be used for load transmission from C1 lateral mass to C3 body, and the mesh cage can be modified according to need as a plate with good results in an emergency.

Keywords: C2 giant cell tumor; C2 prosthesis; Iliac crest autograft; Technical note.

MeSH terms

  • Adult
  • Axis, Cervical Vertebra / surgery*
  • Bone Plates
  • Bone Transplantation / methods*
  • Giant Cell Tumors / surgery*
  • Humans
  • Ilium / transplantation
  • Male
  • Spinal Fusion / methods*
  • Spinal Neoplasms / surgery*
  • Surgical Mesh
  • Treatment Outcome