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Surgical treatment of giant cell tumor of the cervicothoracic spine with combined anterior and posterior approaches

机译:前后路联合手术治疗颈胸椎巨细胞瘤

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摘要

Generally, giant cell tumors are rare and their localization in the spine is even more so. They are locally aggressive leading to spine instability and neurologic deficits. Radical excision is highly advocated. A role of radiotherapy in these tumors is controversial. We report the case of a giant cell tumor localized in D1 and D2 on a 39-year-old patient, presented with interscapular back pain, paraparesis grade 3/5 and sphincter dysfunction. Thoracic spine computed tomogarphy and magnetic resonance imaging showed a vertebral body tumor in D1 and D2, compressing the spinal cord at the same level. The patient initially underwent decompressive laminectomy of affected levels and stabilized with laminar hooks and rods. Second surgery performed through an anterior approach whereby tumor excision together with corpectomy of D1 and D2 carried out, autograft was placed and plate applied. Three weeks postoperatively, the patient's neurologic deficit recovered fully and back pain subsided.
机译:通常,巨细胞瘤很少见,它们在脊柱中的定位甚至更是如此。它们在局部具有攻击性,导致脊柱不稳定和神经功能缺损。极力主张根治性切除。放射疗法在这些肿瘤中的作用是有争议的。我们报道了一个39岁的病人,位于D1和D2的巨大细胞肿瘤的情况,表现为肩inter间背痛,轻瘫3/5和括约肌功能障碍。胸椎计算机断层扫描和磁共振成像显示在D1和D2中有椎体肿瘤,以相同水平压迫脊髓。患者最初接受了受影响水平的减压椎板切除术,并用层状钩和棒稳定。通过前路手术进行第二次手术,在该手术中进行肿瘤切除以及D1和D2的尸体切除,放置自体移植物并应用钢板。术后三周,患者的神经功能缺损完全恢复,腰痛减轻。

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