Transoral Resection and Reconstruction for Primary Osteogenic Sarcoma of the Second Cervical Vertebra

Abstract

The axis is a very rare location for the occurrence of primary osteosarcoma. Osteosarcoma may histologically mimic chondroblastoma. The axis can be surgically exposed, resected, and instrumented transorally. The stabilization must be augmented by posterior occipitocervical fusion.

The anatomic study of clival screw fixation for the craniovertebral region

“…Goel et al [10] reported a patient with congenital basilar invagination after odontoidectomy performed with plate and screw fixation of the clivus to the body of the 3rd cervical vertebra. It was considered that direct fixation to the clivus may be a more rigid alternative to previously described techniques [11][12][13].…”

A clivus plate fixation for reconstruction of ventral defect of the craniovertebral junction: a novel fixation device for craniovertebral instability

“…It is believed that direct fixation to the clivus is more practical and robust than techniques previously described for the reconstruction after ventral resection of the lesions and decompressions in the CVJ [6,10,11]. Since a novel anterior fixation using the clivus as the sole cephalad anchoring point was applied to one patient with congenital basilar invagination after odontoidectomy [3], a modified Harms mesh and a custom titanium plate technique anchoring at the clivus and C3 were used for the treatment following extensive resection of the upper cervical spine [2,4].…”

Cervical spinal osteosarcoma in an adolescent

“…2 Ozaki et al and the Cooperative Osteosarcoma Study Group have reported better overall survival when wide marginal excision is achieved (compared with intralesional debulking). 3 The limitations of radiotherapy, due to the harmful effects on the spinal cord, can be reduced with advanced techniques. To minimize harm, IMRT and proton radiation therapy allow accurate radiation doses to be delivered effectively to the residual tumour.…”

“…The interval between the ''normal'' radiograph and the second, which showed complete destruction of the C3 body, was only three months. The histology, 8 1 + + + DOD (24) 1979 9 1 + + + DOD (24) NED 1984 10 1 + + + NED (7) 1986 11,à 3 +(2/3) +(3/3) +(1/3) DOD (7-11) 1988 12 1 + + + AWD (24) 1988 13 2 + + À DOD (36) and NED (12) 1988 14 1 + + + DOD (12) 1991 15 1 + + À DOD (7) 1994 16 1 + À + NED (24) 1996 17 1 + + + DOD (24) 2002 4, 1/22 + + + AWD (26) 2001 3 1 + + + AWD (40) 2002 6 1 + À + NED (10) 2004 18 1 + À + DOD (10) 2005 19 1 + + + DOD (2) 2006 20 1 together with the rapid re-growth of the tumour after the first surgery, confirmed the aggressiveness of the tumour. Therefore, a high index of suspicion is required for the diagnosis of cervical spinal osteosarcoma, despite its rarity.…”

“…1,2 It carries a poorer prognosis compared with its long bone counterpart because of limitation of the degree of resection and radiotherapy dosage, related to the proximity of neural tissues. 3 The wider the resection margin, the better the survival. 4 We report an adolescent with cervical spine osteosarcoma which posed a challenge in both diagnosis and treatment.…”