The surgical strategy for eosinophilic granuloma of the pediatric cervical spine complicated with neurologic deficit and/or spinal instability

Nanzhe Zhong, Wei Xu, Tong Meng, Xinghai Yang, Wangjun Yan, Jianru Xiao, Nanzhe Zhong, Wei Xu, Tong Meng, Xinghai Yang, Wangjun Yan, Jianru Xiao

Abstract

Background: Various therapeutic approaches have been proposed for the treatment of pediatric patients with eosinophilic granuloma (EG) of the cervical spine. Our aim was to discuss and present our experience with the individualized surgical intervention of pediatric cervical EG complicated with neurologic deficits and/or spinal instability.

Methods: We retrospectively analyzed the clinical data of 19 children who were diagnosed with cervical EG comor spinal/or spinal instability (evaluated by the Spinal Instability Neoplastic Score, SINS ≥ 7) and treated surgically in our institution.

Results: Lesions involved C1-2 in 7 patients and C3-7 in 12 patients. Anterior tumor resection combined with posterior pedicle screw fixation, anterior approach of excision and instrumentation, and posterior tumor resection combined with pedicle screws instrumentation were selected according to the different locations of tumors. Frankel scale and Oucher scale improved significantly after surgery. There was no morphologic alteration of the neck at follow-up.

Conclusions: Surgery can significantly improve the neurologic status and symptoms. Surgical decision-making must be individually tailored to minimize the influence of surgery on spine growth.

Keywords: Cervical; Eosinophilic granuloma; Pediatric; Surgery.

Figures

Fig. 1
Fig. 1
Case 10: a 5-year-old girl, C2 LCH. a, b Anterioposterior and lateral plain film before operation. c CT scan showed the right appendix of C2 was involved. d, e Anterioposterior and lateral plain film 48 months after operation of anterior tumor resection combined with posterior pedicle screw instrumentation
Fig. 2
Fig. 2
Case 4: a 7-year-old girl, C7 LCH. a, b T1- and T2-weighted MRI images before operation. c, d Anterioposterior and lateral plain film before operation. e, f Anterioposterior and lateral plain film 15 months after operation of anterior tumor resection and miniplate and screw instrumentation

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Source: PubMed

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