Occipitoaxial Posterior Fixation for Recurrence of Anterior Foramen Magnum Tumor : A Case Report

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  • 再発した大後頭孔前方腫瘍に対して後頭骨軸椎後方固定を行った 1 例

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We report the use of occipitoaxial fixation for recurrence of a foramen magnum tumor. A 72-year-old man underwent total resection of a foramen magnum schwannoma via a lateral approach. However, 32 months later, he was hospitalized with severe headache and paralysis of the right upper extremity. MRI showed recurrence of the tumor at the same level. The paralysis progressed and led to respiratory pentaplegia. We performed occipitoaxial pedicle screw fixation and tumor resection. At 19 months after re-operation there was no recurrence of the tumor and radiography revealed occipitoaxial bone union. The advantage of a lateral approach is that it gives good exposure of a tumor located at the anterior foramen magnum, there is no need for retraction of the spinal cord, and no risk of cerebrospinal fluid leakage or infection that often occurs when the anterior approach is used. The use of posterior cervical fixation for cervical spinal tumors is controversial. Here we performed posterior fixation in order to resect the facet joint at C2/3 to obtain good exposure for prevention of excessive bleeding from the extradural venous plexus.

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