One-stage total en bloc spondylectomy by anterior and posterior approaches for lumbar vertebral tumors / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the surgical results of one stage total en bloc spondylectomy (TES) by anterior and posterior approaches for lumbar vertebral tumors and evaluate its benefit for these tumors.</p><p><b>METHODS</b>A total of 21 patients with the lumbar vertebral tumor treated with on stage TES by posterior and anterior approaches from April 2003 to August 2007 were reviewed, which included 14 males and 7 females with an average age of 47.6 years. Thirteen patients were suffered with the primary lumbar vertebral tumors and 8 patients were diagnosed for the lumbar vertebral metastasis tumors. There were 8 of S3, 3 of I A and 2 of II according to Ennekinng stage system. And there were 1 of Grade B, 4 of Grade C, 8 of Grade D, and 6 of Grade E according to Frankel grade system. The spinal reconstruction was obtained by titanium mesh filled with autograft for benign and low-grade malignant tumors and methylmethacrylate-filled titanium mesh for malignant tumors. The spinal stability was enhanced by posterior internal fixation with rod-screw system.</p><p><b>RESULTS</b>The operation time was 250 min and bleed loss was 2100 ml on average. The follow-up period lasted from 1.0 to 5.5 years. All cases had pain before operation, among which 14 cases obtained complete relief and 7 cases obtained partly relief after operation. In all cases with neurological deficit, they improved neurologically by more than one grade using the Frankel grading system. Up to now, 1 patient had be local recurrence after operation and 4 patients were dead on the following time. The others still are alive and no local recurrence.</p><p><b>CONCLUSION</b>One-stage TES by anterior and posterior approaches for lumbar vertebral tumor is feasible, safe and effective to lumbar vertebral tumor resection and stability reconstruction, which has many advantages such as controlling local recurrence, spinal cord decompression thoroughly, relieving the pain, improving the life quality and prolonging the lifetime.</p>