一期前后入路全脊椎切除治疗胸椎骨巨细胞瘤

目的 探讨一期前后联合入路全脊椎切除并脊柱稳定性重建治疗胸椎骨巨细胞瘤的疗效.方法 回顾性分析本院自2001年3月至2007年6月采用一期前后联合入路全脊椎切除及脊柱稳定性重建治疗9例胸椎骨巨细胞瘤患者.结果 术中无死亡病例,无脊髓医源性损伤等并发症发生.所有患者术后获20-52个月(平均29.6个月)随访,术后患者背部疼痛及放射性疼痛基本缓解,8例有神经压迫症状的患者均有不同程度改善.1例患者术后6个月复发,给予放射治疗.影像学复查内固定物固定良好,无脊柱失稳及假关节发生.结论 一期前后联合入路全脊椎切除及脊柱稳定性重建治疗胸椎骨巨细胞瘤可以根治性切除肿瘤,降低肿瘤局部复发的危险,是一种可行且有效的外科治疗技术.

Total en bloc spondylectomy and reconstruction via a simultaneous anterior and posterior approach for giant cell tumor of the thoracic spine

Objective To explore the effoct of total en bloc spondylectomy and reconstruction via a simultaneous anterior and jposterior approach for giant cell tumor of the thoracic spine. Methods Nine consecutive patients of giant cell tumor of thoracic spine treated by total en bloc spondylectomy and reconstruction via a simultaneous anterior and posterior approach between March 2001 to June 2007 were retrospectively reviewed. Results No patients died during operation and none had iatrogenic spinal cord injury or other complications. All the cases had been followed up from 20 to 52 months (mean 29.6 months). The back pain and radiated pain were relieved. And there were8 cases with spinal cord compression symptoms got improved in diferent degree. One patient had developed isolated local recurrence, and treated with radiotherapy. During follow -up, all the internal fixations were well fused and no spine instability and pseudoarthrosis oocurred. Conclusion Total en bloc spondylectomy and reconstruction via a simultaneous anterior and posterior approach for giant cell tumor of the thoracic spine can radically resect the tumor, decrease the risk of local recurrence. This is a feasible and effective technique, and can improve the quality of patient's life.