Roy-Camille R, Saillant G, Bisserié M, Judet T, Hautefort E, Mamoudy P
Rev Chir Orthop Reparatrice Appar Mot. 1981;67(3):421-30.
The authors believe that it is not possible to remove a thoracic vertebra completely by a lateral transthoracic approach. They have operated on three patients in which a thoracic vertebra has been removed completely using an extended posterior approach. The technique described utilizes an extra-pleural bilateral thoracotomy through a single posterior incision. The posterior mediastinum is mobilised and the vertebral bodies freed. The technique is indicated in tumours of the spine compressing or threatening the spinal cord, especially primary local malignant tumours or where adjuvant treatment such as radiotherapy, chemotherapy or radio active drugs are effective. Benign but recurrent tumours such as giant cell tumours or aneurysmal bone cysts are also good indications for this method.
作者认为,经外侧经胸入路不可能完全切除胸椎。他们对3例患者进行了手术,采用扩大后路入路完全切除了胸椎。所描述的技术通过单一后切口进行胸膜外双侧开胸。游离后纵隔并松解椎体。该技术适用于压迫或威胁脊髓的脊柱肿瘤,尤其是原发性局部恶性肿瘤或放疗、化疗或放射性药物等辅助治疗有效的情况。良性但复发性肿瘤,如骨巨细胞瘤或动脉瘤样骨囊肿,也是该方法的良好适应证。