• Jennifer Neva, Brandon W Smith, Jacob R Joseph, and Paul Park.
• Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
• World Neurosurg. 2017 Jun 1; 102: 693.e21-693.e27.

BackgroundAneurysmal bone cysts (ABCs) are rare blood-filled cystic lesions that are found in the long bones and spine. Here, we present a case of an ABC found in the lateral mass and lamina of C1. Lesions in this area provide a surgical challenge because of its difficulty to access as well as its need for reconstruction. We describe a novel use of intraoperative navigation (ION) to assist in the placement of a C1 lateral mass titanium cage.Case DescriptionAn 18-year-old female patient presented with headaches and progressive neck pain. Imaging revealed a large cystic lesion involving the C1 lamina and right lateral mass. The patient underwent ION-assisted aggressive intralesional resection of the ABC and reconstruction of the C1 lateral mass with a static titanium cage, supplemented with posterior fusion from the occiput to C3. At 2-year follow-up, there was no evidence of recurrence and the hardware remained intact.ConclusionsION is a useful aid in assessing the extent of tumor resection and performing cage reconstruction of the C1 lateral mass.Copyright © 2017 Elsevier Inc. All rights reserved.

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