Lord C F, Herndon J H
Clin Orthop Relat Res. 1986 Sep(210):120-7.
Three patients were treated for pathologic fractures of the thoracolumbar spine causing progressive neurologic deficit. An anterior decompression with partial removal of the diseased vertebra was performed with improvement of neurologic function in each patient. Active tumor was not found, but necrotic bone with collapse and secondary kyphosis were the causes of anterior compression of the spinal cord. In two patients, the spine was stabilized with an anterior fibular strut graft that initially provided stability; later collapse progressed and deformity recurred. In the third patient, stabilization was secured with internal fixation that has prevented a recurrent deformity. Late collapse of a vertebral body after irradiation for tumor may be secondary to necrosis resulting from tumor infiltration and/or radiotherapy. Anterior decompression and stabilization with adjunctive internal fixation can be beneficial in selected cases.
三名患者因胸腰椎病理性骨折导致进行性神经功能缺损而接受治疗。对每位患者均进行了前路减压并部分切除病变椎体，神经功能均有改善。未发现活动性肿瘤，但坏死骨伴塌陷和继发性后凸是脊髓前方受压的原因。两名患者采用腓骨支撑植骨前路固定，最初提供了稳定性；但后来仍出现塌陷进展和畸形复发。第三名患者通过内固定获得了稳定，防止了畸形复发。肿瘤放疗后椎体晚期塌陷可能继发于肿瘤浸润和/或放疗导致的坏死。在某些特定病例中，前路减压及辅助性内固定进行稳定治疗可能有益。
