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一种新型的背部模块化固定装置允许对颈椎和颈胸段肿瘤性病变采用改良的手术入路。

A new dorsal modular fixation device allows a modified approach in cervical and cervico-thoracic neoplastic lesions.

作者信息

Huch K, Cakir B, Dreinhöfer K, Puhl W, Richter M

机构信息

Department of Orthopedic Surgery and Spinal Cord Injury (RKU), University of Ulm, Germany.

出版信息

Eur Spine J. 2004 May;13(3):222-8. doi: 10.1007/s00586-003-0656-2. Epub 2004 Jan 20.

Abstract

INTRODUCTION

The aim of this study was to improve the management of cervical tumor osteolysis. A new modular rod-screw implant system for the posterior instrumentation of the occipito-cervical, cervical and cervico-thoracic spine (neon occipito cervical system, Ulrich, Germany) is available since 2000. K-wire guided pedicle screws are used, CT-guided instrumentation is possible. Previous studies have demonstrated increased biomechanical stability compared to established posterior cervical systems.

METHODS

The cervical and cervico-thoracic spine of 8 patients (6 males, 2 females, mean age 62 years, range 48-77 years) with osteolysis due to plasmocytoma (n=2), bronchial (n=2), mammary (n=2), esophageal (n=1) and pancreatic (n=1) carcinoma were instrumentated since June 2001.

RESULTS

A stable fixation without loosening or failure of the fixation system was achieved in all cases. No impairment of the neurogical status was observed.

CONCLUSION

Posterior instrumentation of the cervical spine including the occipito-cervical and the cervico-thoracic region with a new modular angle-stable rod-screw implant system offers good stabilization and allows simultaneous decompression. Since tumor masses are predominantly located in the anterior portion of the spine blood loss can be reduced.

摘要

引言

本研究旨在改善颈椎肿瘤骨溶解的治疗。自2000年起可获得一种用于枕颈、颈椎和颈胸段脊柱后路内固定的新型模块化棒-螺钉植入系统(德国乌尔里希公司的neon枕颈系统)。使用克氏针引导椎弓根螺钉,也可行CT引导下的内固定。既往研究表明,与现有的颈椎后路系统相比,其生物力学稳定性有所提高。

方法

自2001年6月起,对8例因浆细胞瘤(n = 2)、支气管癌(n = 2)、乳腺癌(n = 2)、食管癌(n = 1)和胰腺癌(n = 1)导致骨溶解的患者(6例男性,2例女性,平均年龄62岁,范围48 - 77岁)的颈椎和颈胸段脊柱进行内固定。

结果

所有病例均实现了稳定固定,固定系统无松动或失效。未观察到神经功能状态受损。

结论

使用新型模块化角度稳定棒-螺钉植入系统对包括枕颈和颈胸段区域在内的颈椎进行后路内固定可提供良好的稳定性,并允许同时进行减压。由于肿瘤肿块主要位于脊柱前部,可减少失血。

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