Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 20032, China.
Eur Spine J. 2011 Apr;20(4):655-60. doi: 10.1007/s00586-010-1618-0. Epub 2010 Nov 13.
Total en bloc spondylectomy (TES) for vertebral tumour was previously reported by Tomita through a single posterior approach using a T-saw. A modified total en bloc spondylectomy (MTES) technique is reported in the present study. The disc puncture needle with a sleeve was used to obliquely puncture from the posterior to the anterior direction. A T-saw was inserted through the sleeve and led out to the operator's side by the leading clamp. The disc was partially cut with the saw from its medial to lateral aspect. After a spinal fixation rod was applied on the operator's side, the residual discs on the opposite side were cut as described above. Six patients with thoracic vertebral tumours were operated on using the MTES technique. Five patients showed improvement in their neurological deficits postoperatively. There was no evidence of tumour recurrence at the final follow-up. The MTES is technically feasible with improved practicality and safety.
全脊椎整块切除术（TES）曾被 Tomita 报道过，该手术通过单一的后路入路，使用 T 型锯完成。本研究报道了一种改良的全脊椎整块切除术（MTES）技术。采用带有套管的椎间盘穿刺针从后路向前路斜行穿刺。将 T 型锯插入套管，并通过前导夹将其引导至术者侧方。从椎间盘的内侧向外侧部分切割锯片。在术者侧方应用脊柱固定棒后，如上所述切割对侧的残余椎间盘。6 例胸腰椎肿瘤患者采用 MTES 技术进行手术。5 例患者术后神经功能缺损得到改善。末次随访时无肿瘤复发证据。MTES 技术具有更高的实用性和安全性，技术上是可行的。
