Tanaka Masato, Sugimoto Yoshihiro, Misawa Haruo, Takigawa Tomoyuki, Kunisada Toshiyuki, Ozaki Toshifumi
Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
Acta Med Okayama. 2012;66(4):363-8. doi: 10.18926/AMO/48692.
Spinal deformity is an important clinical manifestation after surgery for spinal cord tumors. One-third of patients who receive laminectomies and irradiation of the spinal column develop scoliosis, kyphosis, or kyphoscoliosis. Recent reports indicate good results after scoliosis surgery using segmental pedicle screws and a navigation system, but these reported studies have not included surgery for post-laminectomy kyphosis. Hooks and wires are ineffective in such patients who undergo laminectomy, and there are also high perioperative risks with insertion of pedicle screws because landmarks have been lost. Here, we report on the 5-year follow-up of a 13-year-old male patient with post-laminectomy and post-irradiation thoracic kyphoscoliosis after surgical treatment of spinal astrocytoma. Posterior segmental pedicle screw fixation was performed safely using a computer-assisted technique. The authors present the first case report for treatment of this condition using a navigation system.
脊柱畸形是脊髓肿瘤手术后的一种重要临床表现。接受椎板切除术和脊柱照射的患者中有三分之一会出现脊柱侧凸、后凸或脊柱后凸侧凸。最近的报告表明，使用节段性椎弓根螺钉和导航系统进行脊柱侧弯手术后效果良好，但这些报告的研究并未包括椎板切除术后后凸畸形的手术。钩和钢丝对接受椎板切除术的患者无效，而且由于标志点已消失，插入椎弓根螺钉的围手术期风险也很高。在此，我们报告一名13岁男性患者在脊髓星形细胞瘤手术治疗后发生椎板切除术后和放疗后胸段脊柱后凸侧凸的5年随访情况。使用计算机辅助技术安全地进行了后路节段性椎弓根螺钉固定。作者首次报告了使用导航系统治疗这种疾病的病例。
