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单侧小关节固定术作为挽救性手术:两例伴有广泛骨质破坏的颈椎原发性骨肿瘤病例报告

Unilateral facet fixation as a salvage procedure: Report of two cases with cervical primary bone tumors with extensive bone destruction.

作者信息

Shah Abhidha, Prasad Apurva, Vutha Ravikiran, Goel Atul

机构信息

Department of Neurosurgery, K. E. M. Hospital and Seth G. S. Medical College, Navi Mumbai, Maharashtra, India.

K. J. Somaiya Medical College, Hospital and Research Center, Mumbai, Maharashtra, India.

出版信息

J Craniovertebr Junction Spine. 2023 Apr-Jun;14(2):201-204. doi: 10.4103/jcvjs.jcvjs_53_23. Epub 2023 Jun 13.

Abstract

We describe cases of two patients with primary cervical bone tumors that resulted in extensive destruction of bones of the region. In the first patient, the tumor and its growth resulted in the destruction of C3-C5 vertebral bodies and the unilateral destruction of facets and pedicles. In the second case, there was focal destruction of the body and odontoid process and unilateral pedicle and facet of C2. Tumor resection and spinal stabilization were the aims of the surgery. In both cases, unilateral fixation of facets was done. In the first patient, multi-segmental transarticular fixation by Camille's technique was done, and in the second patient, unilateral lateral mass plate and screw fixation was done by the Goel technique. Solid bone fusion of spinal segments was observed at more than a 2-year follow-up in both cases. Based on this experience, it appears that unilateral facetal fixation can provide firm stability and can be used when other more frequently and popularly used techniques are either not available or possible.

摘要

我们描述了两例原发性颈椎骨肿瘤患者的病例,这些肿瘤导致了该区域骨骼的广泛破坏。在第一例患者中,肿瘤及其生长导致C3 - C5椎体破坏以及关节突和椎弓根的单侧破坏。在第二例中,C2椎体和齿突以及单侧椎弓根和关节突有局灶性破坏。手术的目的是肿瘤切除和脊柱稳定。两例均进行了关节突单侧固定。在第一例患者中,采用卡米尔技术进行了多节段经关节固定,在第二例患者中,采用戈尔技术进行了单侧侧块钢板螺钉固定。两例在超过2年的随访中均观察到脊柱节段的坚实骨融合。基于这一经验,似乎单侧关节突固定可以提供牢固的稳定性,并且在其他更常用的技术不可用或不可行时可以使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fce/10336898/8e1317ea0feb/JCVJS-14-201-g001.jpg

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