• Pankaj K Singh, Mohit Agrawal, Shashwat Mishra, Deepak Agrawal, Dattaraja Sawarkar, Amandeep Jagdevan, Satish Verma, Ramesh Doddamani, Rajesh Meena, Kanwaljeet Garg, Poodipedi S Chandra, and Shashank S Kale.
• Department of Neurosurgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. Electronic address: drpankajsingh11@gmail.com.
• World Neurosurg. 2020 Aug 1; 140: 241-246.

BackgroundLocally aggressive vertebral body tumors of the axis must be treated with wide local excision for best outcome. Reconstruction of the load-bearing vertebra needs to be done after tumor resection in such a manner so as to give stable, long-term fusion in this young population.MethodsWe describe the management strategy of a 25-year-old acutely quadriplegic patient, with respiratory distress, with a C2 giant cell tumor. The use of a novel iliac crest graft modification used for C2 reconstruction along with a modified mesh cage used as an anterior plate has been reported.ResultsThe patient had a good outcome at 18 months' follow-up, with neurologic improvement and a solid fusion.ConclusionsIliac crest autograft is inexpensive and easy to harvest and can be considered as a C2 prosthesis, especially in a resource-constrained setting. Modified iliac crest graft can be used for load transmission from C1 lateral mass to C3 body, and the mesh cage can be modified according to need as a plate with good results in an emergency.Copyright © 2020 Elsevier Inc. All rights reserved.

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