Artikel
One-stage vertebral body replacement and posterior stabilisation allows rapid mobilisation for severely ill tumour patients
Der einzeitige Wirbelkörperersatz mit dorsaler Stabilisierung erlaubt eine schnelle Mobilisierung bei schwerkranken Tumorpatienten.
Suche in Medline nach
Autoren
-
A.M.D. München
- Neurochirurgische Klinik, Universitätsklinik des Saarlandes
-
T.R. Pitzen
- Neurochirurgische Klinik, Universitätsklinik des Saarlandes
-
D. Barbier
- Neurochirurgische Klinik, Universitätsklinik des Saarlandes
-
W.I. Steudel
- Neurochirurgische Klinik, Universitätsklinik des Saarlandes
| Veröffentlicht: | 8. Mai 2006 |
|---|
Gliederung
Text
Objective: Due to more radical tumour treatment concepts, there is an increasing number of long time survivors among tumour patients. They very often receive metastasis within the thoracic spine. If these are involving the vertebral body and the posterior structures, anterior-posterior-combined surgery may be necessary. Combined two-stage-surgery may be connected with a higher incidence of severe complications. Therefore, for these severely ill patients one-stage-surgery, only via posterior approach - with however two-column-stabilisation - can be expected to be an ideal treatment option. This would allow rapid mobilisation combined with a possibly favourable complication rate. Aim of this retrospective study was to analyse the early outcome of our patients suffering from instable spinal lesions and receiving one-stage vertebral body replacement and posterior stabilisation with respect to early mobilisation and complication rate.
Methods: 20 patients suffering from destruction of at least one thoracic vertebra underwent posterior approach, decompression including vertebral body resection and combined vertebral body replacement using Polymethylmethacrylate and posterior stabilisation (pedicle-screw-rod-system). We looked for tumour histology, mean time of stay in bed as well as hardware failure rate and clinical complications.
Results: The mean duration until mobilisation was 5 days. No postoperative implant loosening was observed. The main postoperative complications were pleural effusions (30%) and disorders of wound healing (20%). These however, did not influence hospital stay or quality of live. There were no complications on account of immobilisation like decubitus or thrombosis/lung embolism.
Conclusions: One-stage vertebral body replacement with posterior stabilisation is an appropriate surgical method for severely ill tumour patients with respect to early mobilisation and sufficient stabilisation.
