Chen Yen-Jen, Hsu Horng-Chaung, Chen Kun-Hui, Li Tsai-Chung, Lee Tu-Sheng
Departments of Orthopedic Surgery, China Medical University Hospital, Taichung, Taiwan.
Spine (Phila Pa 1976). 2007 Oct 15;32(22):E623-6. doi: 10.1097/BRS.0b013e3181573eea.
We retrospectively reviewed surgical results of posterolateral transpedicular partial corpectomy without anterior vertebral reconstruction in 23 consecutive patients with symptomatic metastatic spinal cord compression at thoracic spine.
To evaluate postoperative outcomes and survival rates of patients undergoing transpedicular partial corpectomy without anterior vertebral reconstruction.
The need for anterior reconstruction after radical resection of vertebral body tumors has been emphasized by several authors. However, the stability of thoracic spine is substantially increased by the rib cage. The role of reconstruction may be not necessary in thoracic spine when partial corpectomy is performed.
From November 2001 to November 2006, 23 patients with symptomatic metastatic spinal cord compression at thoracic spine underwent palliative surgery using a transpedicular partial corpectomy without anterior vertebral reconstruction. The indication for surgery was neurologic progression due to spinal cord compression.
Patients ranged in age from 20 to 88 years (mean, 57.0 years). Neurologic improvement by at least one Frankel grade was noted in 19 of 23 cases (82.6%). Overall, 73.9% of patients (17 of 23) could walk after surgery. There was no intraoperative mortality. Median survival time was 11.3 months. There was no implant failure.
The results of this study suggest that the stability of implants can be maintained up to 55.8 months without anterior vertebral reconstruction in thoracic spine.
我们回顾性分析了23例连续性胸段有症状转移性脊髓压迫患者接受后路经椎弓根部分椎体切除术且未进行前路椎体重建的手术结果。
评估接受经椎弓根部分椎体切除术且未进行前路椎体重建患者的术后结果及生存率。
多位作者强调椎体肿瘤根治性切除术后进行前路重建的必要性。然而,胸廓可显著增加胸椎的稳定性。当进行部分椎体切除术时,胸椎重建可能并非必要。
2001年11月至2006年11月,23例胸段有症状转移性脊髓压迫患者接受了采用经椎弓根部分椎体切除术且未进行前路椎体重建的姑息性手术。手术指征为脊髓压迫导致的神经功能进展。
患者年龄范围为20至88岁(平均57.0岁)。23例中有19例(82.6%)神经功能至少改善一个Frankel分级。总体而言,73.9%的患者(23例中的17例)术后能够行走。术中无死亡病例。中位生存时间为11.3个月。无内固定失败情况。
本研究结果表明,胸椎不进行前路椎体重建时,内固定稳定性可维持长达55.8个月。