Posterior 360-degree stabilisation of the upper thoracic spine: a technical note.
OBJECTIVE
To describe a technique involving posterior 360-degree stabilisation of the upper thoracic spine: spinal cord decompression, posterior vertebral body replacement, and then posterior instrumentation and intercostal posterolateral vertebral stabilisation.


METHODS
Three men and 4 women aged 41 to 77 (mean, 58) years underwent posterior 360-degree stabilisation of the upper thoracic spine. Their indications for surgery were bone metastasis (n=5), burst fracture (n=1), and osteoporotic collapse with cord compression (n=1). Their clinical and radiological findings and treatment outcomes were retrospectively reviewed.


RESULTS
Pain status of all patients improved after surgery: 4 had severe and 3 had mild pain preoperatively; in 3 pain became minimal and 4 had none postoperatively. All patients except one had Frankel/American Spinal Injury Association scores of E after surgery indicating complete recovery of sensory and motor function. There were no complications related to surgery or instrumentation construct. At the time of review, one patient had died of old age 8.6 years after surgery and another from local recurrence and lung metastasis 5.7 years after surgery. All other patients were living.


CONCLUSIONS
One-stage posterior 360-degree stabilisation and vertebral body replacement is a useful technique for upper thoracic spine surgery.
Timbihurira
G
G
Division of Orthopaedics and Rehabilitation Medicine, Department of Surgery, Faculty of Medicine, University of Fukui, Yoshida-gun, Japan.
Nakajima
H
H
Kobayashi
S
S
Sato
R
R
Yayama
T
T
Uchida
K
K
Horiuchi
Y
Y
Baba
H
H
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D020127:Recovery of Function; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D013125:Spinal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013904:Thoracic Vertebrae; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*