Operative treatment via anterior approaches for cervicothoracic vertebrae tumors： surgical techniques and primary outcome

Objective： To sum up 7 patients with cervicothoracic vertebrae tumors （Cr to T3） from March 1999 and May 2002, who underwent operative treatment via anterior approaches. Methods ：The anterior approaches included low anterior cervical approach and high transthoracic approach. In 5 cases of segments of T1 and above involved, the low anterior cervical approaches were adopted, otherwise the high transthoracic approaches were used（2 cases）. Excision of tumor was carried out according to demands of the Weinstein-Boriani-Biagini （WBB） staging system. Spine stability was reconstructed by bone autografting and instrumentation. There were 4 cases of primary tumor and 3 of metastases. Their mean age was 45. 1 years （23 to 66）. The mean follow-up was 18.9 months （3 to 45）. Results were evaluated by occurrence of complications, improvement of symptoms, local recurrence and mortality. Results： All patients stood surgery well. No significant complications occurred during and after operation. Local pain was significantly alleviated and neurological deficit was improved at least one Frankel grade. Three patients died. Local tumor control was obtained in 6 patients （85.7 % ） until the end of follow-up. Conclusion.-Our experience showed that via low anterior cervical approach and high transthoracic approach, the cervicothoracic vertebrae tumor could be excised safely and adequately. Moreover, excision of tumor according to the WBB surgical staging system and reconstruction of spine stability have made great contribution to local tumor control and the neurological function improvement.

Operative treatment via anterior approaches for cervicothoracic vertebrae tumors: surgical techniques and primary outcome

Objective:To sum up 7 patients with cervicothoracic vertebrae tumors (C7 to T3) from March 1999 and May 2002. who underwent operative treatment via anterior approaches. Methods:The anterior approaches included low anterior cervical approach and high transthoracic approach. In 5 cases of segments of T1 and above involved, the low anterior cervical approaches were adopted, otherwise the high transthoracic approaches were used(2 cases). Excision of tumor was carried out according to demands of the Weinstein-Boriani-Biagini (WBB) staging system. Spine stability was reconstructed by bone autografting and instrumentation. There were 4 cases of primary tumor and 3 of metastases. Their mean age was 45. 1 years (23 to 66). The mean follow-up was 18. 9 months (3 to 45). Results were evaluated by occurrence of complications, improvement of symptoms, local recurrence and mortality. Results: All patients stood surgery well. No significant complications occurred during and after operation. Local pain was significantly alleviated and neurological deficit was improved at least one Frankel grade. Three patients died. Local tumor control was obtained in 6 patients (85. 7%) until the end of follow-up. Conclusion:Our experience showed that via low anterior cervical approach and high transthoracic approach, the cervicothoracic vertebrae tumor could be excised safely and adequately. Moreover, excision of tumor according to the WBB surgical staging system and reconstruction of spine stability have made great contribution to local tumor control and the neurological function improvement.