Exposure of the upper cervical spine for spinal decompression by a mandible and tongue-splitting approach. Case report

Hall, JE; Denis, Francis; Murray, James W. G.

doi:10.2106/00004623-197759010-00023

Cited by 63 publications

(22 citation statements)

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“…1,2 However, if anterior vertebral complex reconstruction with bone grafts and internal fixation is required, an anterior prevascular retropharyngeal approach allows a wider surgical exposure for anterior transarticular atlantoaxial screw fixation or anterior screw and plate fixation of C1-C2, without the need for a transmandibular median labiomandibuloglossotomy (Trotter) approach. 3,4 Furthermore, there are several reported risks associated with the transoral approach, such as the deep and narrow operative field, the potential risk of oropharyngeal bacterial contamination, and the need for routine tracheotomy with accompanying postoperative disturbances of breathing, phonation, and swallowing. [5][6][7] Thirty-five years ago, DeAndrade and MacNab described an anterior approach to the occipitocervical junction.…”

mentioning

confidence: 99%

Minimally Invasive Anterior Approach to Upper Cervical Spine

Fong

DuPlessis²

2005

Journal of Spinal Disorders &Amp; Techniques

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confidence: 99%

Minimally Invasive Anterior Approach to Upper Cervical Spine

Fong

DuPlessis²

2005

Journal of Spinal Disorders &Amp; Techniques

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“…It is typically reserved for lesions for which less invasive approaches do not provide sufficient exposure for resection and/or anterior spinal reconstruction. 6 Its application has been recently reported for a similar procedure in an adult with sarcoma. 3 To our knowledge, however, it has not been reported in a pediatric patient with an aneurysmal bone cyst of the upper cervical spine.…”

Section: Discussionmentioning

confidence: 98%

Resection of an upper cervical aneurysmal bone cyst and spinal reconstruction using a midline mandibular osteotomy in a pediatric patient

McDowell¹,

Hanft²,

Greenberg³

et al. 2014

PED

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The authors report on the surgical management of an extensive lesion of the upper cervical spine that required an uncommon transmandibular approach to facilitate exposure, resection, and stabilization in a pediatric patient. A 6-year-old boy with a large aneurysmal bone cyst of the C-2 vertebra presented with progressive weakness and right-sided neck pain. The lesion extended laterally into the soft tissue of the neck, inferiorly to C-4, and posteriorly around the spinal cord. A transmandibular osteotomy was performed to provide adequate exposure for complete resection of the mass and anterior C1–3 instrumentation and fusion. Subsequently, the patient underwent occiput to C-4 posterior instrumentation and fusion. The patient tolerated the operation well and had regained all function at 3 and 11 months' follow-up. No neurological complications or problems of speech, swallowing, or respiration occurred. Even in pediatric patients, the transmandibular approach for the treatment of upper cervical spine lesions is an effective method of maximizing exposure for complex lesions requiring resection and stabilization.

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“…In that case, the anterior open approach to the upper cervical spine (C1 and C2) was necessary and could be either transoral-transpharyngeal [11][12][13], transmandibular with median labiomandibuloglossotomy (if added exposure is required) [14,15] or lateral retropharyngeal [16][17][18][19], depending on the experience and the needs of the surgeon.…”

Section: Discussionmentioning

confidence: 99%

“…These approaches should be used with care and only in appropriate circumstances because can be debilitating and associated with high risk of significant complications, due to iatrogenic injury to visceral, vascular or neurological structures [11][12][13][14][15][16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic excision of C2 Osteoid Osteoma: a technical case report

et al. 2012

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Purpose The Authors illustrate the feasibility of an open biopsy and complete excision of Osteoid Osteoma involving the C2 vertebral body performed via endoscopic anterior cervical approach. Methods A 23-year-old male patient with history of delayed diagnosis of cervical Osteoid Osteoma underwent evaluation and surgical treatment: the minimally invasive procedure and techniques were described. The clinical features, the radiological findings and the outcome were assessed. Complications and local recurrences were also recorded. Results There were no intra-or post-operative complications. Immediately after surgery the typical Osteoid Osteoma related pain disappeared. At three years follow-up the patient was asymptomatic and considered disease-free: CT-scan and x-Ray showed no local recurrence and C2-C3 interbody fusion with cervical plate in site. Conclusions The endoscopic transcervical surgery represents an interesting option for the treatment of these diseases in difficult areas of the upper cervical spine, also minimizing soft tissue trauma and collateral damage allows patients a faster and complete return to normal function. To our knowledge this is the first report of cervical spine tumor removal using this minimally invasive approach.

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Exposure of the upper cervical spine for spinal decompression by a mandible and tongue-splitting approach. Case report

Cited by 63 publications

References 0 publications

Minimally Invasive Anterior Approach to Upper Cervical Spine

Minimally Invasive Anterior Approach to Upper Cervical Spine

Resection of an upper cervical aneurysmal bone cyst and spinal reconstruction using a midline mandibular osteotomy in a pediatric patient

Endoscopic excision of C2 Osteoid Osteoma: a technical case report

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