在脊柱肿瘤和畸形手术中使用整体切除的椎弓根重建腰椎后柱

IF 1.2 Q3 SURGERY
Spine Surgery and Related Research Pub Date : 2024-06-10 eCollection Date: 2024-09-27 DOI:10.22603/ssrr.2024-0041
Satoshi Kato, Noriaki Yokogawa, Takaki Shimizu, Motoya Kobayashi, Yohei Yamada, Satoshi Nagatani, Satoru Demura
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引用次数: 0

摘要

简介:在涉及大面积前柱切除的高位脊柱截骨术中,恢复截骨部位的后柱结构完整性可减少术后器械植入失败(IF)。本研究旨在描述我们利用整体切除的椎弓进行后方支柱植骨的技术,该技术适用于下腰椎脊柱肿瘤和畸形手术中高位截骨后的后柱重建。技术说明:使用后路,按照全脊椎整体切除术(TES)的手术技术对目标椎弓进行整体切除。椎体切除后,在 TES 中插入椎体笼,或在畸形手术中进行前柱截骨,然后进行矫正,上下相邻椎体的后方元素被分隔出很大的空间。为了创建新的后柱,将整体切除的椎弓旋转 90°,以连接上下椎弓。利用这种技术,将大量由切除的椎体成分制成的骨片置于整体切除的后弓上,作为额外的骨移植。该技术用于三名因脊柱肿瘤而接受 TES 手术的患者,以及一名因成人下腰椎畸形而接受 4 级截骨手术的患者。术后一年,计算机断层扫描显示,所有患者被整体切除的椎弓与相邻椎体的后部元素之间成功实现了骨性融合的结构完整性,且未出现术后IF:结论:这一植骨技术为下腰椎高位截骨后的后柱创造了新的连续性。结论:这一植骨技术在下腰椎高位截骨术后创造了新的后柱连续性,实现了后部椎体的骨融合,避免了术后IF的发生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Posterior Column Reconstruction of the Lumbar Spine Using En Bloc Resected Vertebral Arch in Spinal Tumor and Deformity Surgeries.

Introduction: In high-grade spinal osteotomy involving large anterior column resection, restoration of the structural integrity of the posterior column at the osteotomy site can reduce postoperative instrumentation failure (IF). This study aimed to describe our technique of posterior strut bone grafting using an en bloc resected vertebral arch, which is useful for posterior column reconstruction after high-grade osteotomies during surgeries for spinal tumor and deformity in the lower lumbar spine.

Technical note: Using a posterior approach, en bloc resection of the targeted vertebral arch was performed in accordance with the surgical technique for total en bloc spondylectomy (TES). The posterior elements in the upper and lower adjacent vertebrae were separated by a significant space after vertebral body resection followed by cage insertion in TES or anterior column osteotomy followed by correction in deformity surgery. To create a new posterior column, the en bloc resected vertebral arch was placed at 90° rotation to bridge the upper and lower vertebral arches. Using this technique, an abundant amount of bone chips made from the resected vertebral elements were placed over the en bloc resected posterior arch as an additional bone graft. The technique was used in three patients who underwent TES for spinal tumors and in one patient who underwent grade 4 osteotomy for adult spinal deformity in the lower lumbar spine. One year after surgery, computed tomography showed that the structural integrity of bony fusion was successfully achieved between the en bloc resected arch and the posterior elements of the adjacent vertebrae in all patients and showed no postoperative IFs.

Conclusions: This bone graft technique created new continuity of the posterior column after high-grade osteotomies in the lower lumbar spine. Bone fusion was achieved in the posterior elements to prevent IF after surgery.

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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
71
审稿时长
15 weeks
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