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转移瘤切除术后采用胸腔引流管技术重建颈椎:单中心经验。

Cervical Spine Reconstruction with Chest Tube Technique After Metastasis Resection: A Single-Center Experience.

机构信息

Division of Orthopedics, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Quebec, Canada.

Division of Neurosurgery, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Quebec, Canada.

出版信息

World Neurosurg. 2022 Jan;157:e49-e56. doi: 10.1016/j.wneu.2021.09.088. Epub 2021 Sep 25.

Abstract

BACKGROUND

The silastic tube technique, in which a chest tube is placed into the vertebral body defect and impregnated with polymethyl methacrylate, showed good results in patients with lumbar and thoracic neoplastic diseases. There has been only 1 study about the effectiveness and safety of this technique in patients with cervical metastases. We aimed to report our experience in using this technique to reconstruct the spine after corpectomy for cervical metastasis.

METHODS

All patients with cervical spinal metastasis who underwent surgical treatment using a chest tube impregnated with polymethyl methacrylate in conjunction with anterior cervical plate stabilization were retrospectively recruited. Demographics, tumor histology, revised Tokuhashi score, preoperative and postoperative American Spinal Injury Association score, preoperative and postoperative ambulatory status, perioperative complications, and survival time were collected.

RESULTS

This study included 16 patients. The most common primary tumor site was the lung (6 patients; 37.5%). The mean (SD) survival time was 408 (795) days (range, 1-2797 days), and the median survival time was 72 days (95% confidence interval 28-116 days). Four patients (25%) died within 30 postoperative days. There was no surgical site infection or instrument failure after the surgery. Five patients (31.2%) lived >180 days, and 3 patients (18.8%) lived >360 days. One patient (6.2%) was still alive at the end of the study.

CONCLUSIONS

The silastic tube technique in conjunction with anterior cervical plate stabilization might be safe, effective, and cost-effective for patients with cervical spine metastasis.

摘要

背景

硅橡胶管技术,即将胸管置于椎体缺损处并用聚甲基丙烯酸甲酯浸渍,在治疗腰椎和胸椎肿瘤疾病患者中取得了良好的效果。仅有 1 项研究探讨了该技术在颈椎转移患者中的有效性和安全性。我们旨在报告使用该技术在颈椎转移患者行颈椎切除术后重建脊柱的经验。

方法

回顾性招募了所有接受使用胸管浸有聚甲基丙烯酸甲酯并结合前路颈椎板固定术治疗的颈椎转移患者。收集患者的人口统计学资料、肿瘤组织学、Tokuhashi 评分修订版、术前和术后美国脊髓损伤协会评分、术前和术后步行状态、围手术期并发症和生存时间。

结果

本研究纳入了 16 例患者。最常见的原发肿瘤部位是肺部(6 例;37.5%)。平均(标准差)生存时间为 408(795)天(范围,1-2797 天),中位生存时间为 72 天(95%置信区间 28-116 天)。4 例(25%)患者在术后 30 天内死亡。术后无手术部位感染或器械失败。5 例(31.2%)患者存活时间>180 天,3 例(18.8%)存活时间>360 天。1 例(6.2%)患者在研究结束时仍存活。

结论

硅橡胶管技术结合前路颈椎板固定术可能是安全、有效且具有成本效益的治疗颈椎转移患者的方法。

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