Jorge H Nuñez1,2, Pilar González-Tartière3, Frank Erimeiku1, Ana García DE Frutos4, Manuel Ramírez4. 1. Department of Orthopedic Surgery and Traumatology, University Hospital of Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, Spain. 2. Spine Unit, Department of Orthopedic Surgery, University Hospital of Mutua Terrasa, Barcelona, Spain. 3. Vall d'Hebron Research Institut Barcelona, Barcelona, Spain. 4. Spine Unit, University Hospital of Vall d'Hebron, Barcelona, Spain.
Abstract
BACKGROUND: Fibrous dysplasia (FD) is an uncommon benign intramedullary fibro-osseous lesion. Cervical spine compromise is rare with only cases reported. Currently, the natural history of cervical FD is poorly understood, and its treatment remains controversial. METHODS: A review of the literature was performed to analyze and discuss the management of cervical FD through a case report and literature review. RESULTS: Cervical FD is a rare benign pathology. Clinical presentation is usually casual or only clinical pain. Computed tomography (CT)-guided percutaneous biopsy is a safe and effective technique for evaluation of spinal lesions; however, the accuracy of the preoperative biopsy findings has been disappointing. Although all treatments are valid, no one has been demonstrated to be better. Our proposed treatment, a corpectomy and fixation with a titanium mesh cage filled with allograft bone and an anterior cervical plate, showed good results. CONCLUSIONS: The rarity of cervical FD and the lack of detailed reports with long-term follow-up periods complicate the research on the optimal treatment approach in these cases, but apparently all are valid for pain control. In our case, a corpectomy and fixation with a titanium mesh cage filled with allograft bone and an anterior cervical plate was carried out and showed good results. We submit this surgery option to be considered in these rare type of injuries.
BACKGROUND: Fibrous dysplasia (FD) is an uncommon benign intramedullary fibro-osseous lesion. Cervical spine compromise is rare with only cases reported. Currently, the natural history of cervical FD is poorly understood, and its treatment remains controversial. METHODS: A review of the literature was performed to analyze and discuss the management of cervical FD through a case report and literature review. RESULTS: Cervical FD is a rare benign pathology. Clinical presentation is usually casual or only clinical pain. Computed tomography (CT)-guided percutaneous biopsy is a safe and effective technique for evaluation of spinal lesions; however, the accuracy of the preoperative biopsy findings has been disappointing. Although all treatments are valid, no one has been demonstrated to be better. Our proposed treatment, a corpectomy and fixation with a titanium mesh cage filled with allograft bone and an anterior cervical plate, showed good results. CONCLUSIONS: The rarity of cervical FD and the lack of detailed reports with long-term follow-up periods complicate the research on the optimal treatment approach in these cases, but apparently all are valid for pain control. In our case, a corpectomy and fixation with a titanium mesh cage filled with allograft bone and an anterior cervical plate was carried out and showed good results. We submit this surgery option to be considered in these rare type of injuries.
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