Kawahara N, Tomita K, Matsumoto T, Fujita T
Department of Orthopaedic Surgery, School of Medicine, Kanazawa University, Japan.
Chir Organi Mov. 1998 Jan-Jun;83(1-2):73-86.
It is the purpose of this study to report our new surgical technique and the outcome of total en bloc spondylectomy (TES) to resect the primary spinal tumor as a whole in order to ensure oncological curability. TES consisting of en bloc laminectomy and en bloc corporectomy was performed on 7 patients with primary vertebral tumors between 1989 and 1993. There were 2 osteosarcomas, 1 malignant fibrous histiocytoma, 1 chondrosarcoma, 1 undifferentiated sarcoma, 1 solitary plasmocytoma, and 1 giant cell tumor. All of the patients had partial or complete pain relief after TES. None of the patients worsened neurologically after surgery and there was no local recurrence following TES, except for 1 patient who died 3 months postsurgery as a result of a tumor developing in the mediastinum. The advantage of TES is en bloc resection of the affected vertebrae by marginal or wide margin, not piecemeal pattern. This new surgical technique offers the most radical therapy of primary malignant tumors.
本研究旨在报告我们的新手术技术以及整块全脊椎切除术（TES）的结果，该手术旨在完整切除原发性脊柱肿瘤以确保肿瘤学上的可治愈性。1989年至1993年间，对7例原发性椎体肿瘤患者实施了包括整块椎板切除术和整块椎体切除术的TES。其中有2例骨肉瘤、1例恶性纤维组织细胞瘤、1例软骨肉瘤、1例未分化肉瘤、1例孤立性浆细胞瘤和1例巨细胞瘤。所有患者在TES后疼痛均得到部分或完全缓解。术后无患者神经功能恶化，TES后无局部复发，除1例患者术后3个月因纵隔出现肿瘤而死亡。TES的优点是通过边缘或广泛边缘整块切除受累椎体，而非逐块切除。这种新手术技术为原发性恶性肿瘤提供了最彻底的治疗方法。
