Louie Philip K, Khan Jannat M, Miller Ira, Colman Matthew W
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
Ann Transl Med. 2019 May;7(10):227. doi: 10.21037/atm.2019.04.89.
Total en bloc spondylectomy (TES) involves disruption of the bony neural ring via bilateral pediculotomy and posterior laminectomy followed by the vertebrectomy. All-posterior TES allows for resection of malignant and benign aggressive spine tumors with minimal morbidity. The purpose of this report is to describe two cases of all-posterior spondylectomy using the recently developed Resegone retractor (K2M, Leesburg, VA, USA) which facilitates an all-posterior resection. The technique is well described and generally includes 3 major portions: a resection of the posterior elements with bilateral costotransversectomy, passage of threadwire saws anterior to the vertebral bodies, and resection of the anterior column. With the device in place, the sawing of the bone can be performed without risking pull-through into the cord, while cutting through the desired path in a smooth and parallel fashion.
整块全脊椎切除术(TES)包括通过双侧椎弓根切断术和后路椎板切除术破坏骨性神经环,随后进行椎体切除术。全后路TES能够以最小的发病率切除恶性和良性侵袭性脊柱肿瘤。本报告的目的是描述两例使用最近开发的Resegone牵开器(美国弗吉尼亚州利斯堡的K2M公司)进行全后路脊椎切除术的病例,该牵开器有助于全后路切除。该技术已得到充分描述,一般包括三个主要部分:双侧肋横突切除术切除后部结构、在椎体前方穿入线锯以及切除前柱。在该装置就位的情况下,可以进行骨锯切,而不会有锯丝穿入脊髓的风险,同时能以平滑且平行的方式切出所需路径。