Quiste óseo aneurismal en la columna cervical en una niña de 10 años…(I)

Beiner, John M. MD *; Sastry, Akhilesh MD +++; Berchuck, Matthew MD [S]; Grauer, Jonathan N. MD [//]; Kwon, Brian K. MD, PhD, FRCSC [P]; Ratliff, John K. MD **; Stock, Gordon H. MD ++; Brown, Andrew K. MD ++; Vaccaro, Alexander R. MD ++

Abstract:

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.