Antero-Lateral Approach and Vertebral Artery Transposition for a Giant Cervical Spine Chordoma With Bilateral Extension: 2-Dimensional Operative Video

Chordoma is a neoplasm originating from notochord cells, with an incidence of 0.5 to 0.8 cases per million.1 Despite benign histopathological findings, it usually has a local aggressive behavior and multiple recurrences.2 Maximal surgical resection is the gold standard treatment, followed by adjuvant therapy.3 The authors report the case of a 41-year-old man who presented with neck pain and dysphagia. Radiological images showed a chordoma in the cervical spine (C1-C5) with bilateral involvement of the vertebral arteries. The tumor was resected through an anterolateral cervical approach, followed by posterior fixation of the spine. The patient was referred for adjuvant combined proton-photon therapy with a favorable outcome. Details of the surgical technique, indications, alternative approaches, and risks are described.4-6The patient consented to the procedure and to the publication of his image.