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采用胫骨同种异体支撑骨移植术治疗骶骨尤因肉瘤次全切除术后重建:1例报告

Reconstruction after Subtotal Sacrectomy for Sacral Ewing's Sarcoma Using Tibial Allograft Strut Grafting: A Case Report.

作者信息

Hirota Ryosuke, Emori Makoto, Terashima Yoshinori, Iba Kousuke, Iesato Noriyuki, Fukushi Ryunosuke, Yoshimoto Mitsunori, Yamashita Toshihiko

机构信息

Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.

出版信息

Case Rep Oncol. 2021 Mar 3;14(1):296-302. doi: 10.1159/000513117. eCollection 2021 Jan-Apr.

Abstract

We present the case of a 15-year-old girl. Two months after becoming aware of pain, she was diagnosed with a sacral tumor and referred to our department. She was diagnosed with a sacral Ewing's sarcoma; after chemotherapy, it was determined that the tumor could be resected, so surgical treatment was performed. The sacrum and ilium were partially resected at the lower end of S1, and the lumbar vertebrae and pelvis were fixed with a pedicle screw and two iliac screws on each side of L3, and the sacral resection was reconstructed with a tibial strut allograft. No tumor recurrence or metastasis has been observed 1 year postoperatively. She developed bladder and rectal dysfunction, but she remained independent in activities of daily living and her daily life was not limited. The bone fusion in the reconstructed area confirmed the lack of instrumentation looseness. Surgical treatment for sacral Ewing's sarcoma was performed to cure the patient. We believe that the tibial allograft contributed to the patient's ability to walk on her own due to its high mechanical stability. Postoperative bone healing was observed with the same material, suggesting that the tibial allograft is useful for similar procedures.

摘要

我们报告一例15岁女孩的病例。在出现疼痛两个月后,她被诊断为骶骨肿瘤并转诊至我科。她被诊断为骶骨尤因肉瘤;化疗后,确定肿瘤可以切除,于是进行了手术治疗。在S1下端部分切除骶骨和髂骨,在L3两侧用椎弓根螺钉和两枚髂骨螺钉固定腰椎和骨盆,并用异体胫骨支撑物重建骶骨切除部位。术后1年未观察到肿瘤复发或转移。她出现了膀胱和直肠功能障碍,但她在日常生活活动中仍能保持独立,日常生活未受限制。重建区域的骨融合证实了内固定未松动。对骶骨尤因肉瘤进行手术治疗以治愈患者。我们认为,异体胫骨因其高机械稳定性有助于患者自行行走。用相同材料观察到术后骨愈合,表明异体胫骨对类似手术有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5734/7983578/774e0dfe2005/cro-0014-0296-g01.jpg

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