Surgical relief for tumor compression of spinal cord and vertebral artery

A 26-year-old woman presented with progressive weakness and myelopathy from a clear cell chondrosarcoma of the cervical spine involving the vertebral artery.

Complexity

The tumor was compressing the vertebral artery, and C6 and C7 nerve roots, requiring en bloc cervical resections and oncological sacrifice of C6 and C7 nerve roots.

Solution

This case involved the need to resect with wide margins a tumor compressing the spinal cord and involving the vertebral artery. Orthopedic cancer specialists, neurosurgeons, plastic surgeons and otorhinolaryngology surgeons staged a wide resection of the tumor with the use of a fibula for reconstruction. To restore full use of the patient's arm, the surgical team's multidisciplinary expertise included a neurology specialist who performed an ulnar fascicular nerve transfer to maximize upper extremity function.

Outcome

More than three years after surgery, the patient remains free of cancer with no pain and excellent function. Notes Mayo orthopedic surgeon Peter S. Rose, M.D.: "It is incredibly gratifying to be able to bring together a team to couple a curative cancer operation with a very good functional outcome for a young woman with a bad tumor."

Feb. 19, 2014