Total en bloc spondylectomy for spinal tumors of L4 or L5 can be achieved by combining the posterior-anterior approach, according to a study published in Spine.
Researchers studied six aggressive benign tumors and four solitary spinal metastases treated with the posterior-anterior approach.
For the posterior approach, dissection of the lumbar nerve roots to the conjunction of the adjacent nerves after en bloc laminectomy by T-saw pediculotomy. The psoas muscle is dissected away from the vertebral body, and the posterior halves of the anterior column at the craniocaudal adjacent levels of the lumbar tumor are cut.
For the anterior approach, major vessels are dissected from the vertebral body, and the anterior halves of the anterior column are cut at the corresponding levels. The tumor vertebral body is removed en bloc and then an anterior spinal reconstruction is performed.
Seven of the 10 cases had no disease evidence at 57 months after the surgery. One case was alive with disease at 66 months, and two cases had a death from the disease. All of the patients improved or preserved neurologic function during the last follow-up visit.
Read the abstract for "Total En bloc Spondylectomy of the Lower Lumbar Spine: A Surgical Techniques of Combined Posterior-Anterior Approach."
Read other coverage on spine studies:
- Study: 2D Virtual Fluoroscopy Acceptable for Pedicle Screw Placement
- Study: Plate-Only Laminoplasty Provides Stable Reconstruction
- Study Shows Minimally Invasive Surgery Effective for Elderly Patients
Researchers studied six aggressive benign tumors and four solitary spinal metastases treated with the posterior-anterior approach.
For the posterior approach, dissection of the lumbar nerve roots to the conjunction of the adjacent nerves after en bloc laminectomy by T-saw pediculotomy. The psoas muscle is dissected away from the vertebral body, and the posterior halves of the anterior column at the craniocaudal adjacent levels of the lumbar tumor are cut.
For the anterior approach, major vessels are dissected from the vertebral body, and the anterior halves of the anterior column are cut at the corresponding levels. The tumor vertebral body is removed en bloc and then an anterior spinal reconstruction is performed.
Seven of the 10 cases had no disease evidence at 57 months after the surgery. One case was alive with disease at 66 months, and two cases had a death from the disease. All of the patients improved or preserved neurologic function during the last follow-up visit.
Read the abstract for "Total En bloc Spondylectomy of the Lower Lumbar Spine: A Surgical Techniques of Combined Posterior-Anterior Approach."
Read other coverage on spine studies:
- Study: 2D Virtual Fluoroscopy Acceptable for Pedicle Screw Placement
- Study: Plate-Only Laminoplasty Provides Stable Reconstruction
- Study Shows Minimally Invasive Surgery Effective for Elderly Patients