Kobayashi Kazuyoshi, Imagama Shiro, Ito Zenya, Ando Kei, Yokoi Kohei, Ishiguro Naoki
Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Asian Spine J. 2016 Apr;10(2):360-5. doi: 10.4184/asj.2016.10.2.360. Epub 2016 Apr 15.
We describe successful vertebrectomy from a posterior approach using a computed tomography (CT)-based navigation system (O-arm) in a 53-year-old man with adenocarcinoma of the posterior apex of the right lung with invasion of the adjacent rib, thoracic wall, and T2 and T3 vertebral bodies. En bloc partial vertebrectomy for lung cancer adjacent to the thoracic spine was planned using O-arm. First, laminectomy was performed from right T2 to T3, and pedicles and transverse processes of T2 to T3 were resected. O-arm was used to confirm the location of the cutting edge in the T2 to 3 right vertebral internal body, and osteotomy to the anterior cortex was performed with a chisel. Next, the patient was placed in a left decubitus position. The surgical specimen was extracted en bloc. This case shows that O-arm can be used reliably and easily in vertebrectomy from a posterior approach and can facilitate en bloc resection.
我们描述了在一名53岁男性患者中,使用基于计算机断层扫描(CT)的导航系统(O型臂)经后路成功实施椎体切除术的过程。该患者患有右肺后尖腺癌,侵犯了相邻肋骨、胸壁以及T2和T3椎体。计划使用O型臂对胸椎旁肺癌进行整块部分椎体切除术。首先,从右侧T2至T3进行椎板切除术,并切除T2至T3的椎弓根和横突。使用O型臂确认在右侧T2至3椎体内部的切割边缘位置,并用凿子对前皮质进行截骨。接下来,将患者置于左侧卧位。整块取出手术标本。该病例表明,O型臂可在后路椎体切除术中可靠且轻松地使用,并有助于整块切除。