Buraimoh Morenikeji A, Yu Charles C, Mott Michael P, Graziano Gregory P
Department of Orthopaedic Surgery, Henry Ford Health System, Detroit, Michigan, USA.
Surg Neurol Int. 2017 Dec 6;8:287. doi: 10.4103/sni.sni_324_17. eCollection 2017.
The sacrum is a rare location for spinal metastasis. These lesions are typically large and destructive by the time of diagnosis, making treatment difficult. When indicated, surgical stabilization offers pain relief and preserves independence in patients with impending and acute pathological sacral fractures.
Three consecutive patients presented with sacral metastases. After either failing radiation therapy or presenting with acute fracture and instability, the patients underwent intralesional excision, bilateral L4 to ilium fusion with instrumentation, and sacroiliac (SI) screw fixation. Pain improved after surgery, and there were no wound healing complications. Two patients could continue walking without any assistive device, while one patient required a walker.
Stabilization with combined modified Galveston fixation and SI screw fixation relieves pain and allows maintenance of independence in patients with sacral metastasis.
骶骨是脊柱转移瘤的罕见发病部位。这些病变在诊断时通常较大且具有破坏性,导致治疗困难。在有指征时,手术稳定可为即将发生和急性病理性骶骨骨折的患者缓解疼痛并维持其独立性。
连续3例患者出现骶骨转移瘤。在放射治疗失败或出现急性骨折及不稳定情况后,这些患者接受了病损内切除、双侧L4至髂骨融合内固定以及骶髂(SI)螺钉固定。术后疼痛得到改善,且无伤口愈合并发症。2例患者无需任何辅助装置即可继续行走,而1例患者需要助行器。
采用改良加尔维斯顿固定术与SI螺钉固定术相结合的稳定手术可缓解骶骨转移瘤患者的疼痛并使其维持独立性。