Retropharyngeal/anterolateral approach for C2 corpectomy.

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Oncology

Background:

• High cervical spine (C1-C2) instability often requires surgical intervention.
• Posterior approaches are common, but transoral approaches carry significant risks like contamination and limited exposure.
• Alternative anterior approaches are needed for complex cases.

Purpose of the Study:

• To present a case treated with the anterolateral/retropharyngeal approach for C2 vertebral body multiple myeloma with fracture.
• To evaluate the efficacy and safety of the anterolateral/retropharyngeal approach for high cervical spine pathologies.
• To highlight this approach as a potential alternative to transoral surgery.

Main Methods:

• A 48-year-old male patient with C2 multiple myeloma and pathologic fracture underwent surgery.
• The anterolateral/retropharyngeal approach was utilized for surgical access to the high cervical spine.
• Surgical technique focused on achieving stability and decompression.

Main Results:

• Successful treatment of C2 vertebral body involvement by multiple myeloma with pathologic fracture.
• The anterolateral/retropharyngeal approach provided adequate exposure to the anterior arch of C1 and C2-4 vertebral bodies.
• The patient tolerated the procedure well, with no reported complications related to the surgical approach.

Conclusions:

• The anterolateral/retropharyngeal approach is a viable and potentially safer alternative to the transoral route for accessing the high cervical spine.
• This approach offers good visualization and access for various pathologies affecting C1-C4.
• It may be particularly beneficial in cases with high risk of contamination or limited surgeon experience with transoral techniques.