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Endoscopic-Assisted C2 Transverse Process Mass Excision.

Jitin Bajaj1, Shailendra Ratre1, Yad Ram Yadav1

  • 1Department of Neurosurgery, NSCB Medical College, Jabalpur, Madhya Pradesh, India.

Neurology India
|June 25, 2021
PubMed
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A minimally invasive endoscopic anterior retropharyngeal approach (ARPA) successfully removed a C2 transverse process osteochondroma in a young patient. This technique offers a safe and effective option for challenging high-cervical tumors.

Area of Science:

  • Neurosurgery
  • Minimally Invasive Surgery
  • Spinal Oncology

Background:

  • C2 transverse process exostoses are rare and pose surgical challenges due to proximity to critical neurovascular structures.
  • The anterior retropharyngeal approach (ARPA) is rarely reported for high-cervical transverse process masses, with no prior endoscopic applications.
  • Minimally invasive techniques are increasingly sought for complex spinal pathologies.

Observation:

  • A 14-year-old female presented with chronic neck pain.
  • CT imaging revealed a 6.5 cm³ mass at the C2 transverse process, abutting the vertebral artery.
  • The mass extended into the lateral mass of the C2 vertebra.

Findings:

  • A minimally invasive endoscopic anterior retropharyngeal approach (ARPA) was performed.
Keywords:
Case reportcraniovertebral junctionneoplasmsneuroendoscopyspinal neoplasmsspine

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  • Complete excision of the C2 transverse process osteochondroma, including its cartilaginous cap, was achieved without complications.
  • Histopathological analysis confirmed the mass as an osteochondroma.

    • Implications:

    • Endoscopic ARPA is a viable and safe minimally invasive surgical option for treating high-cervical tumors like C2 transverse process osteochondromas.
    • This approach may reduce morbidity associated with traditional open surgeries for similar pathologies.
    • Successful management of this rare tumor highlights the potential of endoscopic techniques in complex spinal surgery.