Aneurysmal bone cysts (ABCs) of the cervical spine are rare occurrences accounting for about 2% of all cases. Having a propensity to develop in the pediatric population, it generally involves the posterior elements with occasional extension to the facets and body of one vertebral level. Surgical treatment of high cervical ABC in pediatric patients is challenging. Where as complete tumor resection should be attempted for the best chance for cure, spinal fusion should be added to correct the defects created by resection to minimize the risk of postoperative instability. This paper presents a multi-level giant expansile ABC of the high cervical spine involving all three spinal columns in a 13-year-old girl and discuss the surgical management. Surgical treatment in this patient included complete tumor excision and circumferential fusion in two stages without any neurovascular injury. The safety and efficacy of this method, especially in the pediatric population is discussed in view of pertinent literature.
Keywords: Aneurysmal bone cysts; circumferential fusion; giant; pediatric.