Upper cervical spine chordoma: A case study

Cervical chordomas are rare, slow-growing, but locally aggressive tumors. Predominantly found in people 50-69 years old, a chordoma arises from remnants of the primitive notochord. It is most often found in the sacrococcygeal or skull base areas. However, it can be found throughout the spine. Because chordomas are slow growing, they may reach considerable size before the patient becomes symptomatic. Surgical resection with a wide margin is the only curative procedure. Usually, because of tumor location and infiltration, this is not possible. Although this type of tumor is generally considered radioresistant, radiation therapy is often prescribed after surgical resection. The following case study illustrates the clinical presentation, surgical interventions, and neuroscience nursing considerations for a patient undergoing a posterior stabilization as well as a midline mandibulotomy-glossotomy approach for an upper cervical spine chordoma resection.