Orthopaedic Department of Peking University Third Hospital, Beijing Key Laboratory of Spinal Disease Research, No 49. North Garden Road, HaiDian District, 100191, Beijing, China.
Sci Rep. 2020 Jun 4;10(1):9108. doi: 10.1038/s41598-020-65326-0.
This study is to test feasibility, safety and the outcome of sagittal en bloc resection of paravertebral primary tumors in the thoracic and the lumbar spine. Sagittal en bloc resection was planned based on WBB classification and performed via combined anterior-posterior or anterior-posterior-lateral approach in 9 consecutive patients with aggressive benign or malignant paravertebral primary tumors in the thoracic and lumbar spine. Surgical margins were evaluated both radiologically and histopathologically. Follow-up data regarding survival rate, local control, morbidity, hardware failure and postoperative function were collected at around 2 years after surgery. En bloc resection was achieved in all patient with wide margin in 7/9 patients, marginal and intralesional margin in 2/9 patients. Survival rate and local control rate were 100%. There were 4/9 cases of major complications and 2/9 cases of minor complications with an overall morbidity rate of 67% (6/9). All but one patient with intraoperative spinal cord injury were free of neurological deficits and fully mobile in absence of any indication of hardware failure. With a careful choice of surgical procedure, sagittal en bloc resection of paravertebral primary tumor in the thoracic and lumbar spine is feasible, safe and effective.
本研究旨在测试胸腰椎旁原发性肿瘤经矢状位整块切除术的可行性、安全性和疗效。根据 WBB 分类，对 9 例胸腰椎侵袭性良性或恶性旁原发性肿瘤患者，采用前路联合后路或前路联合后路-外侧入路进行矢状位整块切除术。手术切缘通过影像学和组织病理学进行评估。术后约 2 年收集患者的生存率、局部控制率、发病率、内固定失败和术后功能等随访资料。9 例患者均达到整块切除，其中 7 例为宽切缘，2 例为边切缘和瘤内切缘。患者的生存率和局部控制率均为 100%。有 4 例患者出现严重并发症，2 例患者出现轻微并发症，总发病率为 67%（6/9）。除 1 例术中脊髓损伤患者外，所有患者均无神经功能缺损，活动自如，无内固定失败迹象。通过仔细选择手术方式，胸腰椎旁原发性肿瘤的矢状位整块切除术是可行、安全且有效的。
