ANTERIOR CERVICAL VERTEBRAL BODY RESECTION AND BONE-GRAFTING FOR BENIGN AND MALIGNANT-TUMORS

Vertebral-body excision and bone-grafting for traumatic, infectious, or degenerative lesions of the cervical spine have been done for many years, but to our knowledge, the first report on the use of this procedure for neoplastic disease was by Bailey in 1952. Since that time, there have been sporadic single case reports. In view of the limited experience in this area, a clinical research project was undertaken by the Cervical Spine Research Society. Twenty cases are analysed. There were eight primary malignant tumors; seven primary benign tumors, one osteoblastoma, and five metastatic lesions. Through a standard anterior approach, as much of the involved vertebra and tumor was removed as possible, and fifteen iliac-crest, four fibular, and one tibial graft were inserted. In the benign lesions, the anterior approach proved to be curative in all seven patients, with no recurrences and complete resolution of any neural deficit. In patients with malignant lesions, this approach proved its value by decompressing the cord and providing stability. Its palliative value should be emphasized. It improves the quality of the patient's life and prevents quadriparesis, despite the poor over-all prognosis.