Department of Trauma and Orthopaedics, Frimley Park Hospital, Frimley, Surrey, United Kingdom.
Global Spine J. 2015 Apr;5(2):140-3. doi: 10.1055/s-0034-1387809. Epub 2014 Aug 21.
Study Design Case report. Objectives Decompression of metastatic spinal cord compression has been shown to improve quality of life and prolong ambulation in patients undergoing palliative treatment. We report a case of metastatic cervical myelopathy treated with a combined approach using corpectomy and stabilization together with balloon kyphoplasty to allow adequate decompression and immediate stability in a patient with significant destruction of adjacent vertebral bodies. Methods The cervical spine was approached anteriorly and decompressed with a C7 corpectomy. Subsequent stability was achieved with insertion of a trabecular metal cage. Balloon kyphoplasty was used to treat lytic lesions within the posterior body of the adjacent vertebrae for pain relief and increased stability. Additional stability was achieved through the application of an anterior plate. Results Full limited decompression and stabilization were successfully achieved. The patient had no further neurologic deterioration and made modest improvements that allowed a return to independent ambulation. Conclusion This limited approach may be an option for patients with metastatic spinal cord compression, lytic destruction of adjacent vertebral bodies, and limited life expectancy.
研究设计 病例报告。目的 姑息性治疗的转移性脊髓压迫减压已被证明可改善生活质量并延长患者的活动能力。我们报告了一例转移性颈髓病患者，采用前路椎体次全切和稳定术联合球囊后凸成形术治疗，在临近椎体严重破坏的患者中实现了充分减压和即刻稳定。方法 颈椎前路入路，行 C7 椎体次全切减压。随后插入板状金属笼以获得稳定性。球囊后凸成形术用于治疗相邻椎体后体的溶骨性病变以缓解疼痛和增加稳定性。通过应用前路板进一步增加稳定性。结果 实现了充分的有限减压和稳定。患者没有进一步的神经恶化，并取得了适度的改善，使他能够恢复独立行走。结论 对于伴有转移性脊髓压迫、临近椎体溶骨性破坏和预期寿命有限的患者，这种有限的方法可能是一种选择。
