Balancing spinal stability and future mobility in the cervical spine: surgical treatment of a case of osteoblastoma with secondary aneurysmal bone cyst

Background contextThe combination of osteoblastoma and aneurysmal bone cyst (ABC) in the cervical spine is a relatively rare occurrence in the general population. The diagnosis and surgical management of osteoblastoma and ABCs have been previously described in a small number of case reports/series and orthopedic texts. Lesions of the cervical spine pose challenges to surgeons that require preoperative planning and intraoperative decisions to ensure an appropriate patient outcome. Complete resection has been shown to be the most effective method for preventing recurrence; however, balancing spinal stability, future mobility, and complete resection is especially important in active young patients.PurposeWe describe a modern approach to the surgical management of osteoblastoma with secondary ABC of the cervical spine with 4-year clinical and radiographic follow-up. Included in this report is a comprehensive review of the literature related to osteoblastoma, ABCs, and surgical issues pertinent to them.Study designAn independent retrospective case review combined with a review of current literature was performed.Patient sampleA single patient with a combination of osteoblastoma and secondary ABC is presented.Outcome measuresDuring 4 years of follow-up, the patient has been evaluated with plain radiographs for subluxation or rotation of the cervical spine. Postoperative assessments for pain and range of motion were also collected.MethodsThe medical, pathologic, and radiographic records of a case of osteoblastoma with secondary aneursymal bone cyst of the cervical spine were reviewed. A computer-based literature search of the PubMed database was used to compile a comprehensive review of the topic.ResultsThe diagnosis and surgical treatment of osteoblastoma with secondary ABC in the cervical spine are discussed in the context of a literature review. The surgical management of this lesion was dictated by the size and location of the mass as well as the impact of the surgical resection on surrounding structures in terms of spinal stability and future mobility.ConclusionsThe combination of osteoblastoma and ABC in the cervical spine is an uncommon occurrence in the general population. In the cervical spine, careful surgical planning and a case-by-case evaluation must be implemented to minimize morbidity and recurrence for every patient.