Chou Dean, Acosta Frank, Cloyd Jordan M, Ames Christopher P
Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143-0350, USA.
J Neurosurg Spine. 2009 May;10(5):397-403. doi: 10.3171/2009.2.SPINE08472.
En bloc resection of chordoma has been shown to be critical for prolonging long-term survival and disease-free intervals in patients. Cervical spine chordomas pose special challenges because of the vertebral arteries and critical nerve roots involved. Multilevel chordomas pose even greater challenges because of the need to remove multiple segments of the spine in 1 piece without tumor violation. Although there have been 2 case reports describing multilevel spondylectomy for cervical chordoma, to the authors' knowledge, there are no reports of parasagittal osteotomies for en bloc resection of multilevel cervical chordomas. The use of these osteotomies allows us to avoid intralesional resection and adhere to the oncological principle of en bloc tumor excision. The authors report their management of 3 multilevel cervical chordomas and describe their technique of en bloc tumor removal using parasagittal osteotomy.
整块切除脊索瘤已被证明对延长患者的长期生存率和无病生存期至关重要。颈椎脊索瘤由于涉及椎动脉和重要神经根而带来特殊挑战。多级脊索瘤带来的挑战更大，因为需要整块切除多个脊柱节段而不侵犯肿瘤。尽管有2例病例报告描述了颈椎脊索瘤的多级椎体切除术，但据作者所知，尚无关于采用矢旁截骨术整块切除多级颈椎脊索瘤的报道。使用这些截骨术使我们能够避免瘤内切除，并坚持肿瘤整块切除的肿瘤学原则。作者报告了他们对3例多级颈椎脊索瘤的治疗，并描述了使用矢旁截骨术整块切除肿瘤的技术。
