Surgical Treatment of a C3-osteoblastoma with Cord Compression and Encompassing the Vertebral Artery via Combined Approach

Abstract

Background Osteoblastoma is a rare and benign osteoid-producing primary bone tumor that affects mainly the long bones. 36% of these tumors are observed around the spine and the vast majority arises around the posterior. Case Presentation: This report describes a case of C3 osteoblastoma occurring in a 22-years old male. He represented with cervical pain and quadriparesia. Cervical CT and MRI demonstrated an osteolytic mass that invade anterior and posterior elemant of C3 and cause severe cord compression. Because of the close proximity of the osteoblastoma to the vertebral artery canal and cord total resection of tumor was a challenging decision. To prevention of vertebral artery injury, laminectomy and partial resection of tumor was done with posterior approach and bilateral vertebral arteries preserved and then fussed with lateral mass screw. For best reconstruction and stability, total C3 corpectomy and anterior fusion with allograft and plate was done via anterior cervical approach. Conclusions Osteoblastoma in cervical spine with involvement of anterior and posterior part of vertebrae is a rare pathology and can encase vertebral artery. This case has favorable prognosis after 2 sessions surgery and adequate rehabilitation.