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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.
- Source :
-
World neurosurgery [World Neurosurg] 2020 Oct; Vol. 142, pp. 239-245. Date of Electronic Publication: 2020 Jul 11. - Publication Year :
- 2020
-
Abstract
- 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.<br />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.<br />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.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Autografts diagnostic imaging
Autografts drug effects
Bone Resorption diagnostic imaging
Bone Transplantation trends
Cervical Vertebrae diagnostic imaging
Chondrosarcoma diagnostic imaging
Diphosphonates administration & dosage
Female
Follow-Up Studies
Humans
Imidazoles administration & dosage
Spinal Neoplasms diagnostic imaging
Time Factors
Bone Resorption drug therapy
Bone Transplantation methods
Cervical Vertebrae surgery
Chondrosarcoma surgery
Plastic Surgery Procedures methods
Spinal Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1878-8769
- Volume :
- 142
- Database :
- MEDLINE
- Journal :
- World neurosurgery
- Publication Type :
- Report
- Accession number :
- 32659359
- Full Text :
- https://doi.org/10.1016/j.wneu.2020.07.012