title: [Therapy of thoracolumbar vertebra tumor by total spondylectomy and spine reconstruction through posterior approach].
abstract: OBJECTIVE
  To explore the surgical procedure and effectiveness of total spondylectomy and spine reconstruction through posterior approach to treat thoracolumbar vertebra tumor.
  
  
  METHODS
  Between June 2004 and July 2008, 14 cases of thoracolumbar vertebra tumor underwent one-stage total spondylectomy through posterior approach and spine reconstruction with posterior pedicle screw system and bone graft. There were 11 males and 3 females with a mean age of 47.2 years (range, 36-60 years). The disease duration was 3-15 months. Affected segments included T3 in 1 case, T4 in 3 cases, T8 in 3 cases, T9 in 2 cases, T10 in 3 cases, T12 in 1 case, and L1 in 1 case. The postoperative pathological results were 3 cases of bony giant cell tumor, 1 case of osteoblastoma, 2 cases of osteosarcoma, and 8 cases of metastatic tumor. According to Tomita et al. grading system, there were 1 case of type II, 5 cases of type III, 3 cases of type IV, and 5 cases of type V. According to Frankel classification of preoperative spinal cord function, 3 cases were rated as grade B, 4 as grade C, 5 as grade D, and 2 as grade E.
  
  
  RESULTS
  Wound healing by first intention was obtained in all cases, and no blood vessel and nerve injury occurred. Fourteen patients were followed up 11-64 months (mean, 32.5 months). The local pain was relieved significantly. At 6-8 months after operation, the X-ray films and CT showed that bone graft fusion at Bridwell I grade was achieved. At 10 months, the postoperative spinal cord function was improved from grade B to grade D in 2 cases, from grade C to grade D in 1 case, and the other 9 cases reached grade E. The patients had normal walking function. Two patients died of liver metastasis and brain metastasis at 11 and 15 months postoperatively, respectively; 1 patient with osteoscarcoma died of lung metastasis at 16 months; and 1 case of osteoscarcoma developed local recurrence at 8 months postoperatively. Internal fixation was reliable without loosening and breakage and the spine was stable.
  
  
  CONCLUSIONS
  Total spondylectomy and spine reconstruction through posterior approach is an effective method with advantages of relative minimal injury, radical tumor excision, low local recurrence, and adequate spinal cord decompression.
authors.affiliation: Department of Orthopaedics, Affiliated Hospital of North Sichuan Medical College, Nanchong Sichuan, 637000, PR China. spine173@yahoo.cn
authors.forename: Cheng
authors.initials: C
authors.lastname: Jiang
authors.forename: Junwu
authors.initials: J
authors.lastname: Ye
authors.forename: Peng
authors.initials: P
authors.lastname: Wei
mesh_terms: D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013125:Spinal Neoplasms / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery*