New posterior column reconstruction using titanium lamina mesh after total en bloc spondylectomy of spinal tumour

Abstract

Purpose To investigate the usefulness of titanium lamina mesh for posterior column reconstruction after total en bloc spondylectomy in patients with spinal tumour and evaluate the radiographic outcomes of this method. Method Eight patients who underwent total en bloc spondylectomy with posterior column reconstruction using titanium lamina mesh and bone graft to treat a spinal tumour were included in this study. The mean age at the time of surgery was 50.6 years (range, 16.5-70.9 years) and the mean follow-up duration was 50.2 months (range, 28.1-68.7 months). The pathological lesions were located from the T2 to L1 vertebrae. There were four patients in each primary and metastatic tumour group. For the posterior column reconstruction, titanium lamina mesh was used and bone graft was applied over the lamina mesh. Radiographic evaluation was used to investigate the displacement of lamina mesh and union of the grafted bone above lamina mesh. Results At the postoperative six month follow-up, a bony bridge on the titanium mesh between upper and lower adjacent lamina was observed in all cases, except for one with infection. On the last follow-up, there was no collapse or displacement of titanium lamina mesh, and there was no instability or malalignment of the spinal column. Conclusions Posterior column reconstruction using titanium lamina mesh during total en bloc spondylectomy for spinal tumour was a useful surgical option that provided new lamina reconstruction for stability of spinal column and protection of the neural elements.

Total En Bloc Spondylectomy Combined with the Satellite Rod Technique for Spinal Tumors

“…Because the anatomical structure of the spine is complex, radical spinal oncology resection for spinal neoplasms is nearly impossible [18,19]. Although piecemeal or intralesional excisions may yield the complete resection of tumors, these procedures are associated with a high risk of local recurrence due to tumor contamination and residual tumors [20].…”

“…Considering that TES is indicated for patients with a longer life expectancy [8], solid spinal reconstruction is essential for the long-term quality of life of patients due to its longevity [19]. A biomechanical study demonstrated that multi-segmental posterior xation with anterior column reconstruction can provide better stability than short xation and that xation should be extended to 2 ~ 3 levels above and below the resected vertebrae [23].…”

“…Cage subsidence, a history of radiotherapy, and a low spinal level of involvement have been con rmed to be risk factors related to rod fracture [7,9,24,25]. The survival time of spinal tumor patients is longer when primary tumors and metastatic tumors are resolved, so reconstruction of the three columns of the spine with additional posterior column reconstruction is very important [19]. The satellite rod technique, a multirod construct, has been proven to have the potential to reduce pseudarthrosis and fatigue fracture at the 3-column osteotomy site by enhancing the stability and stiffness of the construct for adult spinal deformity correction [10].…”

Therapy for thoracic lumbar and sacral vertebrae tumors using total spondylectomy and spine reconstruction through posterior or combined anterior-posterior approaches

“…One-stage posterior total spondylectomy and spine reconstruction can be used to treat primary malignant tumors in the spine, including chordoma, osteosarcoma and chondrosarcoma. In addition, benign upper thoracic vertebra tumors with the potential for invasion or a higher recurrence rate, such as giant cell tumors, can also be treated by TES (18). Other tumors that lead to nerve dysfunction and compression fractures, as well as those metastatic tumors in a single vertebra also require TES.…”

Clinical Investigations on Metastatic Epidural Spinal Cord Compression Treated by Separation Surgery Versus Separation Surgery Combined with Vertebroplasty Combined with Interstitial Implantation of 125I Seeds

“…It seriously affects the life span and quality of life. Treatment of MESCC mainly includes traditional tumor resection, such as laminectomy and decompression, partial vertebral body resection, and total en-bloc spondylectomy [4][5] . With advancements in surgical techniques, many patients who had been completely paralyzed can now recover their postoperative neurological function.…”