Surgical treatment of cervical spine fibrous dysplasia: technical case report and review

Neurosurgery. 1999 Jun;44(6):1342-6; discussion 1346-7.

Abstract

OBJECTIVES AND IMPORTANCE: Cervical spine compromise by fibrous dysplasia is rare; only 20 cases have been reported. Treatment was surgical in six cases, but the management differed among the other cases. In this retrospective case report, we analyze and discuss the surgical treatment of this condition in the context of previous reports. CLINICAL PRESENTATION: A 35 year-old woman presented 1 week after the onset of spontaneous neck and left arm pain, which increased 48 hours later. A physical examination revealed only slight neck stiffness. Her previous history was unremarkable. Plain radiographic, radioisotope bone scanning, and computed tomographic studies were performed. The body of the fifth cervical vertebra was collapsed. INTERVENTION: A C5 corpectomy was performed, and the spine was reconstructed with a block of biocompatible osteoconductive polymer and a plate with four bicortical screws. Pathologic examination revealed fibrous dysplasia. The postoperative course was uneventful, and the pain disappeared. Radiographs obtained postoperatively demonstrated good spinal alignment. The patient was discharged after 7 days. Three years later, she continued to have no pain, and spine stability was preserved. CONCLUSION: Good results can be achieved in the surgical treatment of dysplastic tissue with the use of instruments for spine reconstruction and synthetic grafting to prevent invasion.