Single-stage posterior spondylectomy, circumferential decompression and reconstruction using mesh cage for spinal tumors.
OBJECTIVE
To explore the feasibility and clinical results of circumferential decompression and three-column reconstruction through single-stage posterior transpedicular approach for spinal tumor treatment.


METHODS
Totally, 24 patients with spinal tumor underwent tumor resection and spinal reconstruction through single-stage posterior transpedicular approach. Preoperatively, according to the Frankel classification, 12 patients were grade E, 9 grade D, and 3 grade C. Anterior column was reconstructed with non-expandable titanium cages. Posterior segmental instrumentation was used to maintain the stability of spine in all cases. Anterior and posterolateral fusion was performed with autograft and allogenic bone. The following data were followed up in these patients: deformity angle, local recurrence, neurological function, and spinal bony fusion.


RESULTS
The average operating time and blood loss was 5.6 hours and 3,400 ml respectively. No intraoperative and postoperative complications were observed in this group. Postoperatively, 21 patients were Frankel grade E, 2 grade D, and 1 grade C. Four patients reported significant functional restoration and twenty patients reported complete resolution of pain. At follow-up (range, 6-42 months), implant failure or recurrent neurological symptoms was not found.


CONCLUSIONS
The tumor resection and spinal reconstruction through single-stage posterior transpedicular approach is a safe and effective technique for the treatment of spinal tumor. It can fully decompress the neurological structures, correct the kyphosis, and achieve early weight-bearing. This technique can improve life quality for the patients with spinal tumor.
Zhu
Yong
Y
Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Zhao
Hong
H
Qiu
Giu-Xing
GX
Zhang
Jian-Guo
JG
Tian
Ye
Y
Li
Shu-Gang
SG
Yuan
Suo-Mao
SM
D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods; D013125:Spinal Neoplasms / Q000601:surgery*; D013526:Surgical Mesh; D055815:Young Adult