Cervical spondylectomy for chondroblastoma of the cervical spine with tetraplegia: Case report

Abstract

Introduction: chondroblastoma is a rare benign neoplasm of the bone, only nine cases of chondroblastoma occuring in the vertebra are reported in the literature, including six in the cervical vertebrae, there was only one case of tetraparesis in the literature. A chondroblastoma of fourth cervical vertebra with tetraplegia is reported, here imaging studies showed an expansile destructive lesion in vertebral body of C4 and posterior components C3,C4,C5. We emphasize the occurrence of tetraplegia caused by chondroblastoma in the cervical spine and prompt adequate surgery should be performed as soon as possible to restore the neurologic deficit. Clinical Date: A 27 years old man who suffered neck pain and progressive severe weakness of all four limbs and sphincter disturbances admitted to hospital emergently Imaging studies showed an expancile destructive lesion of the C4 vertebral body and posterior compartments of C3,C4,C5 with extraoseous involvement Spondylectomy is performed for patient during two stages, firstly after corpectomy of C4 the vertebral body was reconstructed by autologous iliac bone graft and fixation of C3-graft-C5 bodies was performed with metal screwes and plate. In second stage, after laminectomy of C3,C4,C5 and removing of extradural and extraoseous components of tumor, posterior fusion was performed by using autologous fibula bone graft and then fixation of bone graft to C2,C6,C7 laminae is done by sublaminar wiring. Results: The patient has left the hospital a week after first operation with relative good recovery of lower and upper limbs forces. Second operation performed after 2 month for maximal resection of tumor and posterior fixation. After 6 month follow up the patient had no significant finding only with a few paresthesia in right upper limb. Conclusion: Therefore chondroblastoma should be included in the differential diagnosis a expansile destuctive lesion of the spine and prompt adequate surgery should be performed as soon as possible to restore the neurologic deficit.