[In-vivo change of the spine canal after surgical corrections of severe and rigid kyphoscoliosis].

Objective: To measure the length changes of the spine canal of patients with severe kyphosis after treatments of deformity using osteotomy surgeries. Methods: Retrospectively investigated the data of 10 severe kyphosis patients who were treated between August of 2016 and December of 2018 at Beijing Chaoyang Hospital (5 with Ponte and 5 with posterior vertebra column resection (VCR) osteotomy surgeries). For each patient, the full-spine X-Ray images were used to measure Cobb angles before and after the surgery; 3D CT images were used to construct a 3D model of the spine, including the T(2) to L(2) vertebrae and the spine canal. The 3D model was then used to measure the spinal canal lengths (SCLs) between the upper and lower vertebrae (U/LEV) and between T(2)-L(2) vertebrae at 5 locations on the spine canal cross section (anterior, central, posterior, left and right locations), and the vertical distance between the T(2) and L(2) vertebrae before and after the surgery. The data were statistically analyzed using t tests. Results: For the 5 patients of Ponte osteotomy, the Cobb angles were improved by 89°±17°(56%±11%) and 84°±16°(56%±8%) in the coronal and sagittal planes respectively after the surgery. The changes of the SCL between the T(2)-L(2) vertebrae were (9.9±4.8) mm and (6.0±12.7) mm, and those were (7.2±5.4) mm and (-0.5±7.9) mm between the U/LEV, respectively at the concave and convex sides of the canal. The vertical distance between the T(2)-L(2) vertebrae increased by (66.1±12.0) mm. For the 5 patients with VCR osteotomy, the Cobb angles improved by 83°±19°(60%±10%) and 82°±22°(56%±10%) in the coronal and sagittal planes, respectively. The changes of the SCL between the T(2)-L(2) vertebrae were (-5.5±5.3) mm and (-14.0±6.6) mm, and those were (-8.3±8.4) mm and (-20.7±11.6) mm between the U/LEV, respectively at the concave and the convex sides of the canal. The vertical distance between the T(2)-L(2) vertebrae increased by (41.5±12.4) mm. Conclusions: The Ponte osteotomy significantly elongates the SCLs, especially at the concave side, and the VCR osteotomy shortens the spinal canal, resulting in significant compression of the spinal cord at the convex side.

Case report of cervical intraspinal primitive neuroectodermal tumor and literature review / 中国综合临床

Objective To investigate the clinical characters and therapy of primitive neuroectodermal tumor(PNET).Methods A retrospective analysis was conducted.A 36-year-old female patient was showed pain and numbness of the right upper limb and back for 6 months.The cervical spine MRI showed a spindleshaped intradural mass right ventrolateral of spinal cord at C5-7 with in homogeneously enhancing.Surgery and pathologic examination confirmed that was PNET.Combiled with a series of literatures to analyse the clinical characters Results Surgery was performed to remove the tumor and decompression combined with radiotherapy.The pathologic examination and immunohistochemical analysis revealed that it was PNET.MRI identified local recurrence in spinal canal at 3 month later after surgery.Conclusion Spinal PNET is an uncommon intraspinal tumor with poor prognosis.Histopathology is the evidence of diagnosis.Optimal therapy has not yet been found.Surgical resection with the combination of chemo-radiotherapy or radiotherapy might get the better outcomes.Multidisciplinary treatment should be further clinical required.