Inhibition of Autograft Bone Resorption by Antibone Resorptive Agents After Spinal Reconstruction Surgery for Extensive Cervical Chondrosarcoma: A Case Report with a 10-Year Follow-Up.
Adult
Autografts
/ diagnostic imaging
Bone Resorption
/ diagnostic imaging
Bone Transplantation
/ methods
Cervical Vertebrae
/ diagnostic imaging
Chondrosarcoma
/ diagnostic imaging
Diphosphonates
/ administration & dosage
Female
Follow-Up Studies
Humans
Imidazoles
/ administration & dosage
Plastic Surgery Procedures
/ methods
Spinal Neoplasms
/ diagnostic imaging
Time Factors
Bisphosphonate
Bone resorption
Chondrosarcoma
Denosumab
Grafted bone
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
16
05
2020
revised:
01
07
2020
accepted:
03
07
2020
pubmed:
14
7
2020
medline:
7
1
2021
entrez:
14
7
2020
Statut:
ppublish
Résumé
For the surgical treatment of spinal malignant tumor, spinal reconstruction with bone graft and instrumentation is necessary after tumor resection, but postoperative complications, including grafted bone resorption, may arise. A 42-year-old Asian woman presented with neck pain, tumorous masses on the neck, and left arm pain. Magnetic resonance imaging and computed tomography of the cervical spine showed extensive malignant spinal tumor. Histological examination of tumor biopsy revealed grade I chondrosarcoma. Complete resection of the tumor was performed using an anterior-posterior approach, followed by anterior iliac bone grafting and posterior spinal instrumentation. No tumor recurrence was observed on magnetic resonance imaging at final follow-up after 10 years. However, grafted bone resorption was identified immediately after surgery due to stress shielding by robust spinal instrumentation. To inhibit resorption of grafted bone, the bisphosphonate minodronate was administered for 5 years from 3 years postoperatively, before being replaced by denosumab from 8 years postoperatively. After use of these antibone resorptive agents, grafted bone resorption stopped. Anteriorly grafted bone resorption due to stress shielding may occur after reconstructive cervical spine surgery with robust posterior spinal instrumentation. Bisphosphonates and denosumab may be considered to inhibit grafted bone resorption.
Sections du résumé
BACKGROUND
For the surgical treatment of spinal malignant tumor, spinal reconstruction with bone graft and instrumentation is necessary after tumor resection, but postoperative complications, including grafted bone resorption, may arise.
CASE DESCRIPTION
A 42-year-old Asian woman presented with neck pain, tumorous masses on the neck, and left arm pain. Magnetic resonance imaging and computed tomography of the cervical spine showed extensive malignant spinal tumor. Histological examination of tumor biopsy revealed grade I chondrosarcoma. Complete resection of the tumor was performed using an anterior-posterior approach, followed by anterior iliac bone grafting and posterior spinal instrumentation. No tumor recurrence was observed on magnetic resonance imaging at final follow-up after 10 years. However, grafted bone resorption was identified immediately after surgery due to stress shielding by robust spinal instrumentation. To inhibit resorption of grafted bone, the bisphosphonate minodronate was administered for 5 years from 3 years postoperatively, before being replaced by denosumab from 8 years postoperatively. After use of these antibone resorptive agents, grafted bone resorption stopped.
CONCLUSIONS
Anteriorly grafted bone resorption due to stress shielding may occur after reconstructive cervical spine surgery with robust posterior spinal instrumentation. Bisphosphonates and denosumab may be considered to inhibit grafted bone resorption.
Identifiants
pubmed: 32659359
pii: S1878-8750(20)31523-0
doi: 10.1016/j.wneu.2020.07.012
pii:
doi:
Substances chimiques
Diphosphonates
0
Imidazoles
0
YM 529
127657-42-5
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
239-245Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.