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Aneurysmal bone cyst of the second cervical vertebrae causing multilevel upper cervical instability
David A Levin1, Robert N Hensinger, Gregory P Graziano
1Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA. Levind01@yahoo.com
Journal of Spinal Disorders & Techniques
|February 8, 2006
Summary
Aneurysmal bone cysts (ABC) are rare spinal tumors. Prompt surgical treatment, including curettage and fusion, successfully resolved atlantoaxial instability in a pediatric case, preventing neurological damage.
Area of Science:
- Orthopedic Surgery
- Pediatric Neurosurgery
- Spinal Oncology
Background:
- Aneurysmal bone cysts (ABC) are rare, expansile osteolytic bone lesions characterized by vascular tissue and cystic cavities.
- While typically affecting individuals under 20, ABCs can occur in the spine, with upper cervical spine involvement being infrequent.
- Rapidly growing spinal ABCs can lead to instability and neurological compromise, necessitating urgent diagnosis and intervention.
Observation:
- A 6-year-old child presented with an Aneurysmal Bone Cyst (ABC) in the second cervical vertebra.
- The lesion caused significant atlantoaxial and C2-C3 instability.
Findings:
- The patient underwent a staged surgical procedure involving posterior instrumentation (occiput to C4), lesion curettage, and anterior cervical discectomy with fusion (C2-C4).
- Post-operatively, the patient experienced no lasting neurological deficits.
- At 3-year follow-up, the patient remained disease-free.
Implications:
- Aneurysmal bone cysts represent a rare yet severe cause of upper cervical spine instability.
- Timely diagnosis and comprehensive surgical management, including curettage, decompression, and spinal fusion, are crucial for favorable outcomes.
- Effective treatment can prevent potentially devastating spinal cord injuries.