• Surg Neurol · Dec 2009

    Review Case Reports

    One-stage posterior resection is feasible for a holovertebral aneurysmal bone cyst of the axis: a case report and literature review.

    • Li-Yu Fay, Jau-Ching Wu, Wen-Cheng Huang, Yang-Hsin Shih, and Henrich Cheng.
    • Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
    • Surg Neurol. 2009 Dec 1; 72 Suppl 2: S80-5.

    BackgroundFor cervical spine ABC, staged surgery and the combination of both anterior and posterior approaches are usually necessary for lesions involving all 3 (anterior, middle, and posterior) columns of the spine (holovertebral).Case DescriptionA 20-year-old young man presented with quadriplegia and acute urine retention lasting for 3 days in November 2006. The diagnosis of an ABC involving the C2 vertebral body, pedicles, laminae, and spinous process was made by MRI. One-stage surgery with intralesional injection of fibrin glue via the posterior approach only was able to deliver complete resection and spinal stabilization. His neurologic function recovered well, and he was able to walk independently 10 days postoperation. At the 1-year follow-up, image studies of the cervical spine demonstrated good bone fusion without recurrence of ABC. The C2 vertebral body also showed resolution of ABC and good trabeculation.ConclusionsIntralesional injection of fibrin glue during the operation for holovertebral ABC can be beneficial to (1) avoid using an anterior approach for complete resection and reconstruction, which was usually required in previous reports, and (2) effectively decrease the blood loss during surgery.

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