Xiao Jian-ru, Yuan Wen, Teng Hong-lin, Chen Hua-jiang, Wei Hai-feng, Yang Xing-hai, Jia Lian-shun, Zhao Ding-lin
Department of Orthopedics, Changzheng Hospital, Shanghai 200003, China.
Zhonghua Wai Ke Za Zhi. 2005 Jun 15;43(12):795-8.
To study the surgical indications, approaches and the clinical results of the total spondylectomy and instrumentation reconstruction in the treatment of cervical spinal tumor.
From October 1998 to October 2003, 39 patients with lower cervical bone tumors, including 34 cases with primary tumor and 5 cases with metastatic tumor, were admitted and operated on with total spondylectomy. The patients underwent anteroposterior total spondylectomy including anterior cervical plating, titanium mesh reconstruction and posterior instrumentation based on the location of tumor lesions in the lower cervical spine. One vertebral level total spondylectomy was performed in 29 cases, two level in 7 cases and three level in 3 cases.
The postoperative follow-up ranged from 6 months to 4 years. A majority of patients achieved good results postoperatively. Nineteen cases had complete relief of neurological status. One patient died of multiple metastases and systemic failure 24 months later. One case with malignant neurilemmoma developed local recurrence one year postoperatively.
Anteroposterior total spondylectomy and reconstruction can reduce local recurrence, improve neurological function and increase operation therapeutic effect. Meanwhile, the technique of cervical total spondylectomy carries relatively greater risks and should be more attention to the operation indication.
探讨全椎体切除术及器械重建治疗颈椎肿瘤的手术适应证、手术入路及临床疗效。
1998年10月至2003年10月，收治39例下颈椎骨肿瘤患者，其中原发性肿瘤34例，转移性肿瘤5例，均行全椎体切除术。根据下颈椎肿瘤病变部位，患者接受前后路全椎体切除术，包括前路颈椎钢板固定、钛网重建及后路器械固定。单节段全椎体切除术29例，双节段7例，三节段3例。
术后随访6个月至4年。大多数患者术后效果良好。19例神经功能完全恢复。1例患者术后24个月死于多发转移及全身衰竭。1例恶性神经鞘瘤患者术后1年局部复发。
前后路全椎体切除术及重建可减少局部复发，改善神经功能，提高手术治疗效果。同时，颈椎全椎体切除术技术风险相对较大，应更加重视手术适应证。
