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Implantation of C2 prosthesis with dorsal fusion C0-C4 due to pathologic C2 fracture. Case report and literature review
L. Feuerstein, B. Martens, R. Schwizer, T. Forster, M. Ziga
Jazyk angličtina Země Německo
Typ dokumentu časopisecké články, kazuistiky, přehledy
NLK
ProQuest Central
od 1997-01-01 do Před 1 rokem
Medline Complete (EBSCOhost)
od 2000-01-01 do Před 1 rokem
Nursing & Allied Health Database (ProQuest)
od 1997-01-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 1997-01-01 do Před 1 rokem
- MeSH
- axis chirurgie zranění MeSH
- fraktury páteře * chirurgie MeSH
- fraktury spontánní chirurgie etiologie MeSH
- fúze páteře * metody MeSH
- implantace protézy metody MeSH
- krční obratle chirurgie zranění MeSH
- lidé MeSH
- mladý dospělý MeSH
- nádory páteře chirurgie MeSH
- Check Tag
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- přehledy MeSH
INTRODUCTION: Pathological destruction of the axis vertebra leads to a highly unstable condition in an upper cervical spine. As surgical resection and anatomical reconstruction of the second cervical vertebrae represents a life threatening procedure, less radical approaches are preferred and only few cases of C2 prosthesis are described in literature. CASE DESCRIPTION: The focus of this case report is a 21-year-old man with a pathological fracture of C2 managed primarily surgically with the C1-C3 dorsal fusion. Due to the progression of giant cell tumor and destruction of the axis vertebra, C2 prosthesis through anterior approach and dorsal occipito-cervical fusion C0-C4 were performed. Postoperative infection was managed surgically with a 2-staged dorsal debridement, ostheosynthesis material change and autologous bone graft. After a 4 week-intravenous therapy with the ceftriaxone in combination with the amoxicillin/clavulanate, followed by 12 week per oral therapy with amoxicillin/clavulanate in combination with ciprofloxacin, the complete recovery of the infection was achieved. Radiotherapy was initiated 2 months after the last revision surgery and the patient showed a good clinical outcome with stable construct at a 1 year follow-up. A review of literature of all reported C2 prosthesis cases was performed CONCLUSION: C2 prosthesis allows a more radical resection in pathological processes involving the axis vertebra. Combined with the posterior fusion, immediate stability is achieved. Anterior surgical approach is through a highly unsterile oral environment which presents a high-risk of postoperative infection.
1st Faculty of Medicine Charles University Prague Prague Czech Republic
Department of Orthopedics and Traumatology Cantonal Hospital St Gallen St Gallen Switzerland
Spine Center of East Switzerland Cantonal Hospital St Gallen St Gallen Switzerland
Citace poskytuje Crossref.org
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- $a Feuerstein, Laurin $u Spine Center of East Switzerland, Cantonal Hospital St. Gallen, St. Gallen, Switzerland $u Department of Orthopedics and Traumatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
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- $a INTRODUCTION: Pathological destruction of the axis vertebra leads to a highly unstable condition in an upper cervical spine. As surgical resection and anatomical reconstruction of the second cervical vertebrae represents a life threatening procedure, less radical approaches are preferred and only few cases of C2 prosthesis are described in literature. CASE DESCRIPTION: The focus of this case report is a 21-year-old man with a pathological fracture of C2 managed primarily surgically with the C1-C3 dorsal fusion. Due to the progression of giant cell tumor and destruction of the axis vertebra, C2 prosthesis through anterior approach and dorsal occipito-cervical fusion C0-C4 were performed. Postoperative infection was managed surgically with a 2-staged dorsal debridement, ostheosynthesis material change and autologous bone graft. After a 4 week-intravenous therapy with the ceftriaxone in combination with the amoxicillin/clavulanate, followed by 12 week per oral therapy with amoxicillin/clavulanate in combination with ciprofloxacin, the complete recovery of the infection was achieved. Radiotherapy was initiated 2 months after the last revision surgery and the patient showed a good clinical outcome with stable construct at a 1 year follow-up. A review of literature of all reported C2 prosthesis cases was performed CONCLUSION: C2 prosthesis allows a more radical resection in pathological processes involving the axis vertebra. Combined with the posterior fusion, immediate stability is achieved. Anterior surgical approach is through a highly unsterile oral environment which presents a high-risk of postoperative infection.
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- $a Martens, Benjamin $u Spine Center of East Switzerland, Cantonal Hospital St. Gallen, St. Gallen, Switzerland $u Department of Orthopedics and Traumatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
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- $a Ziga, Michal $u Spine Center of East Switzerland, Cantonal Hospital St. Gallen, St. Gallen, Switzerland. michal.ziga@gmail.com $u Department of Neurosurgery, Cantonal Hospital St. Gallen, Rorschacher Strasse 95, St. Gallen, 9001, Switzerland. michal.ziga@gmail.com $u 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic. michal.ziga@gmail.com $u Department of Neurosurgery and Spine Surgery, Cantonal Hospital Lucerne and University of Lucerne, Lucerne, Switzerland. michal.ziga@gmail.com $1 https://orcid.org/000000018071246X
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