An aneurysmal bone cyst in the cervical spine of a 10-year-old girl: A case report

An aneurysmal bone cyst in the cervical spine of a 10-year-old girl: A case report

Beiner J M; Sastry A; Berchuck M; Grauer J N; Kwon B K; Ratliff J K; Stock G H; Brown A K; Vaccaro A R

Spine

2006

2006-06

Study Design. An aneurysmal bone cyst in the neural arch of the fourth cervical vertebra of a 10-year-old girl is reported, along with a brief review of the literature on the topic. Objective. To report the presentation and diagnosis of this disorder along with a discussion of the major pitfalls of treatment. Summary of Background Data. An aneurysmal bone cyst occurs commonly in the second decade, with a predilection for the lumbar spine. With occurrence in the neural arch of a cervical vertebra, the potential for instability following surgical excision is high. Methods. A 10-year-old white female presented with neck pain of 3 months' duration. Diagnostic imaging revealed an expansile lytic lesion in the spinous process and lamina of the fourth cervical vertebra. Surgical treatment consisted of excisional biopsy and a segmental instrumented posterior fusion from C3 - C5. The histopathology was consistent with an aneurysmal bone cyst. Results. Surgical excision consisting of laminectomy and instrumented segmental fusion provided a good clinical result, and minimized the risk and degree of the 2 most common complications: recurrence of the tumor; and postlaminectomy kyphosis, a frequent occurrence in the pediatric population. Conclusions. In pediatric patients who develop a bone tumor of the posterior elements of the cervical spine, careful clinical and radiologic evaluation is necessary to narrow the differential diagnosis. In most cases, a complete excision should be performed if possible. The risk of postlaminectomy kyphosis is high in the pediatric age population. As such, a fusion should be considered whenever a laminectomy is performed in the immature cervical spine. Risk factors for kyphosis include a high cervical level, multiple laminectomy levels, and postoperative irradiation.

Orthopedics; Neurosciences & Neurology; tumors; pathogenesis; laminectomy; decompression; aneurysmal bone cyst; posterior instrumented fusion; postlaminectomy kyphosis; surgical excision

Journal Article or Conference Abstract Publication

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E475-E479

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