Surgical management of Gorham disease involving the upper cervical spine with occipito-cervical-thoracic fusion: a case report.

ABSTRACT

BACKGROUND CONTEXT Gorham disease is a rare osteolytic condition, with only 17 reported cases primarily affecting the cervical spine. PURPOSE: We report the case of a 31-year-old woman with severe kyphotic instability and myelopathy of the upper cervical spine secondary to massive osteolysis of the posterior elements. The surgical management, clinical outcome, and review of the relevant literature are discussed. STUDY DESIGN: This is a case report and a literature review. PATIENT SAMPLE This is a report of one patient with Gorham disease of the cervical spine. METHODS: We report the case of a 31-year-old woman with Gorham disease affecting the upper cervical spine. Combined posterior and anterior stabilization and fusion was performed from the occiput to the thoracic spine. RESULTS: Six-year follow-up with annual computed tomography imaging showed solid fusion from the occiput to T2. No spread or local recurrence has developed to date. CONCLUSIONS: Correction of severe instability with myelopathy due to Gorham disease of the upper cervical spine was achieved through posterior and anterior occipito-cervical-thoracic fusion.