Stabilization of metastatic lesions affecting the second cervical vertebra

Area of Science:

• Oncology
• Neurosurgery
• Orthopedic Surgery

Background:

• Metastatic spine disease presents a growing healthcare challenge.
• The C2 vertebra has unique biomechanical properties, making isolated C2 lesions of particular interest.
• Isolated C2 metastatic lesions are uncommon.

Purpose of the Study:

• To review surgical outcomes for metastatic lesions specifically affecting the C2 (axis) vertebra.
• To evaluate the efficacy and safety of surgical stabilization techniques for C2 lesions.

Main Methods:

• A retrospective review of surgical spinal stabilization cases over four years.
• Identification of six patients with metastatic disease involving the C2 vertebra.
• Analysis of case notes and radiological data for presentation, outcomes, and complications.

Main Results:

• Five patients underwent surgical stabilization, primarily using posterior instrumentation from the occiput or C1 to the subaxial cervical spine.
• Median survival post-surgery was 283 days.
• No infections, venous thromboembolism (VTE), or implant failures occurred; all patients maintained Frankel E grade neurological function.

Conclusions:

• Metastatic lesions of the C2 vertebra are rare but can be managed effectively.
• Tailored stabilization strategies, including occipitocervical fixation, demonstrated success in maintaining spinal stability and symptom resolution in this series.