整块脊椎切除术及硬脊膜切除术治疗脊索瘤：病例报告
En bloc vertebrectomy and dural resection for chordoma: a case report.
作者信息
Biagini Roberto, Casadei Roberto, Boriani Stefano, Erba Fabio, Sturale Carmelo, Mascari Carmelo, Bortolotti Carlo, Mercuri Mario
机构信息
Oncologic Department, Rizzoli Orthopaedic Institute, Bologna, Italy.
出版信息
Spine (Phila Pa 1976). 2003 Sep 15;28(18):E368-72. doi: 10.1097/01.BRS.0000084644.84095.10.
STUDY DESIGN
Case report.
OBJECTIVES
Report a surgical technique for dural reconstruction after vertebrectomy.
SUMMARY OF BACKGROUND DATA
None available.
METHODS
Clinical case analysis: chordoma from T12 to L2 with infiltration of the dura.
RESULTS
Forty-six months after vertebral resection and reconstruction, the patient is disease free.
CONCLUSIONS
Wide en bloc resection is required for local control in chordoma. When the tumor permeates the dura, resection not including the dura is intralesional with high risk of local recurrence. Therefore, a proper wide resection consists in vertebrectomy removing the dura infiltrated by the tumor. The two-stage dural reconstruction had strongly limited the leakage of liquor during surgery, and the dural patch provided extra strength anteriorly, where the dural suture is more difficult.
研究设计
病例报告。
目的
报告一种椎体切除术后硬脑膜重建的手术技术。
背景资料概述
无可用资料。
方法
临床病例分析：T12至L2脊索瘤伴硬脑膜浸润。
结果
椎体切除及重建术后46个月，患者无疾病复发。
结论
脊索瘤的局部控制需要进行广泛整块切除。当肿瘤侵犯硬脑膜时，不包括硬脑膜的切除属于瘤内切除，局部复发风险高。因此，合适的广泛切除包括切除受肿瘤浸润的硬脑膜的椎体切除术。两阶段硬脑膜重建在手术期间极大地限制了脑脊液漏，并且硬脑膜补片在前部提供了额外的强度，而此处硬脑膜缝合更困难。
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