Currier Bradford L, Papagelopoulos Panayiotis J, Krauss William E, Unni Krishnan K, Yaszemski Michael J
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Spine (Phila Pa 1976). 2007 Apr 20;32(9):E294-9. doi: 10.1097/01.brs.0000261411.31563.37.
En bloc resection of a chordoma of the C5 vertebra with wide surgical margins.
To present the surgical technique of total spondylectomy for a chordoma of the C5 vertebral body.
Malignant bone tumors require wide resection. Wide resection by total en bloc spondylectomy is difficult or not feasible for malignant vertebral tumors of the cervical spine due to the peculiar anatomic complexity of this region, including the vertebral arteries and the neural structures. There are no previous reports of en bloc resection of cervical spine tumors with wide surgical margins.
Using staged posterior and anterior approaches, a total en bloc spondylectomy and spine arthrodesis was performed. En bloc excision of a C5 chordoma was achieved using a threadwire T-saw (Tomita and Kawahara, Kanazawa, Japan) with surgical margins free of tumor. The patient received postoperative adjuvant proton beam radiation therapy.
The patient remains disease-free 9 years after the operation.
Total en bloc spondylectomy with wide surgical margins is feasible for malignant bone tumors of the cervical spine.
整块切除C5椎体脊索瘤并获得广泛手术切缘。
介绍C5椎体脊索瘤全脊椎整块切除术的手术技术。
恶性骨肿瘤需要广泛切除。由于颈椎区域解剖结构特殊，包括椎动脉和神经结构，对于颈椎恶性椎体肿瘤，通过全脊椎整块切除术进行广泛切除困难或不可行。此前尚无关于颈椎肿瘤整块切除并获得广泛手术切缘的报道。
采用分期前后路手术，进行全脊椎整块切除术和脊柱融合术。使用线锯（日本金泽市富田和川原公司生产）整块切除C5脊索瘤，手术切缘无肿瘤残留。患者术后接受辅助质子束放射治疗。
患者术后9年无疾病复发。
对于颈椎恶性骨肿瘤，整块切除并获得广泛手术切缘是可行的。
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