One stage total en bloc spondylectomy (TES) by posterior approach alone for thoracic vertebral tumors.

Abstract

Objective To investigate the surgical Results of one stage total en bloc spondylectomy by posterior approach alone for thoracic vertebral tumors. Methods Total 32 patients with thoracic vertebral tumor treated with on stage TES by posterior approach from 2004 were reviewed. 18 cases suffered with the primary thoracic vertebral tumors, and 14 cases were diagnosed for the thoracic metastasis tumors including 5 cases of breast cancer, 4 cases of renal carcinoma, 3 case of thyroid eancer, 2 ease of lung cancer. Accord-ing to Ennekinng stage system, there were 3 cases for S2, 6 for S3, 4 for Ⅰ A, 3 for Ⅰ B, 2 for Ⅱ. And there were 2 cases for Grade A, 5 for Grade B, 8 for Grade C, 10 for Grade D,7 for Grade E according to Frankel grade system. Results The operation time is 270 min on average (230-420 min) and bleed loss is 2100 ml on average (1200-4200 ml) on the operation. The follow-up period lasted from 6 months to 3.2 years. All cases had got less pain after operation, and the VAS pain scores had attain 2.1 score from the 8.3 on the postperative time of 3 week. The SF-36 score increased from 39 to 79 on the postperative time of 3 week. In all cases with neurological deficit, they improved neurologically by more than one grade. Up to now, only 2 patients had be local recurrence after operation among the primary thoracic vertebral tumors and 8 patients had dead on the following time. The others still are alive and no local recurrence. Conclusion One-stage TES by posterior approach is feasible, safe and effective to thoracic vertebral tumor resection, which has many advantages such as controlling local recurrence, spinal cord decompression thoroughly, relieving the pain, improving the life quality and prolonging the lifetime. Key words: Thoracic vertebrae; Neoplasms; Spinal cord compression; Spinal fusion