General Editor: Luiz Vialle

Authors: Ilya Laufer, JJ Verlaan (on behalf of AOSpine Knowledge Forum Tumor)

Metastatic tumors Occipitocervical, unstable, high ESCC

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Glossary

General considerations

For C0-C2 tumors a posterior approach is recommended.

Nonoperative treatment
Main indication Skill Equipment
Patient not fit for surgery due to medical comorbidities or very advanced metastatic disease. Basic surgical experience, no specialized skills Basic equipment only

Nonoperative treatment consists of radiotherapy, and if needed, brace stabilization to prevent ranges of motion that cause pain.

Occipitocervical fusion
Main indication Skill Equipment
All C1 and C2 tumors Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Advantages (for C2 tumors)

  • Avoidance of C2 nerve root manipulation
  • Less dissection at C1 level

Disadvantages

  • Significant range of motion limitation
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

V1.0 2019.01.06