Usefulness of three-dimensional full-scale modeling of surgery for a giant cell tumor of the cervical spine

• Published in: Spinal cord 2007-03, Vol.45 (3), p.250-253
• Main Authors: Yamazaki, M, Akazawa, T, Okawa, A, Koda, M
• Format: Article
• Language: English
• Subjects: Adult; Anatomy; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Bone Screws; case-report; Cerebrospinal fluid. Meninges. Spinal cord; Cervical Vertebrae - pathology; Cervical Vertebrae - surgery; Development. Senescence. Regeneration. Transplantation; Fundamental and applied biological sciences. Psychology; Giant Cell Tumor of Bone - surgery; Human Physiology; Humans; Male; Medical sciences; Models, Anatomic; Nervous system (semeiology, syndromes); Neurochemistry; Neurology; Neuropsychology; Neurosciences; Orthopedic surgery; Spinal Fusion; Spinal Neoplasms - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tomography, X-Ray Computed; Vertebrates: nervous system and sense organs
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/sj.sc.3101959

Study design: Case report. Objectives: To report a case with giant cell tumor (GCT) of C6 vertebra, in which three-dimensional (3-D) full-scale modeling of the cervical spine was useful for preoperative planning and intraoperative navigation. Setting: A university hospital in Japan. Case report: A 27-year-old man with a GCT involving the C6 vertebra presented with severe neck pain. The C6 vertebra was collapsed and the tumor had infiltrated around both vertebral arteries (VAs). A single-stage operation combining anterior and posterior surgical procedures was scheduled to resect the tumor and stabilize the spine. To evaluate the anatomic structures within the surgical fields, we produced a 3-D full-scale model from the computed tomography angiography data. The 3-D full-scale model clearly showed the relationships between the destroyed C6 vertebra and the deviations in the courses of both VAs. Using the model, we were able to identify the anatomic landmarks around the VAs during anterior surgery and to successfully resect the tumor. During the posterior surgery, we were able to determine accurate starting points for the pedicle screws. Anterior iliac bone graft from C5 to C7 and posterior fixation with a rod and screw system from C4 to T2 were performed without any complications. Postoperatively, the patient experienced relief of his neck pain. Conclusion: The 3-D full-scale model was useful for simultaneously evaluating the destruction of the vertebral bony structures and the deviations in the courses of the VAs during surgery for GCT involving the cervical spine.