A Clinical Report of Total Resection and Double Titanium Cage Reconstruction for Lumbar Spinal Metastases Via a Single Posterior Approach

Liu Shuai; Li Zhengwei; Feng Dapeng

Abstract：Objective To evaluate the clinical effects of total resection and double titanium cage reconstruction on patients with lumbar spinal metastases.Methods According to the inclusion criteria,we prospectively selected 11 patients with lumbar spinal metastases of our hospital from January 2014 to January 2016.All patients underwent a total recection via a single posterior approach and double titanium cage reconstruction meanwhile adjuvant chemoradiotherapy was performed to prevent systemic and local tumors after surgery.VAS score,ASIA impairment scale,status of tumor relapse and the success of internal fixation were analyzed to assess the clinical effects and security of our surgical method.Results Local pain or radicular leg pain was relieved for all patients postoperatively.Significant improvements in neurological function were achieved in 9 patients (81.8%),while 2 patients received a preoperative ASIA impairment scale.The mean operation time was 5.7 h,with an average blood loss of 2 100 mL.Follow-up time lasted 5 to 16 months (Mean=10 months) during which three patients died of the disease and one patient suffered local recurrence.None of the 11 patients suffered major postoperative complications such as dural injury,cerebrospinal fluid leakage,vascular injury,wound infection and other complications.And no instrumentation failure,titanium cage prolapse and loss of intervertebral height during the follow-up period.Conclusion The total resection and double titanium cage reconstruction via a single posterior approach is feasible,safe and effective for special selected cases with poor-prognosis lumbar spinal metastases and less than 1 year of survival.