Clinical Observation on the Treatment of Upper Thoracic Metastatic Tumors by One-stage Posterior Approach Total Vertebral Resection Combined with Bone Cement Infuse and Screw Fixation

Xue Wen; Guan Xiaoli; Liu Lin

Abstract：Objective To investigate the clinical effects of one-stage posterior approach total vertebral resection combined with bone cement infuse and screw fixation for upper thoracic metastatic tumors.Methods A retrospective review was conducted on 11 consecutive patients (from March 2014 to June 2016),with an average age of (61.6±18.3) years old.A total of 251 vertebrae were involved.All of them were metastatic tumors,including breast cancer (4 cases), lung cancer (3 cases),rectal cancer (1 case),thyroid carcinoma (1 case),esophageal cancer (1 case),and prostate canc-er (1 case).VAS scores from 3 to 5 points (good),covering 2 of 11 cases;6 to 8 points (general)in 3 cases;8 to 10 points (poor)in 6 cases,with an average of 7.7 points.All the patients were treated with one-stage posterior total verte-bral resection and pedicle screw fixation combined with bone cement perfusion.Results The average surgery time was (155±37.2)min (120～210 min);the intraoperative blood loss was (1100±324)mL (800～2000 mL).There were no pneumothorax,epidural damage,nervous symptoms or other operation-related complications,nor any internal fixation and bone cement perfusion associated with blood vessels or nervous inj ury perioperative.The average follow-up time of patients was (16.3±13.7)months (6～33 months).The mean preoperative VAS score was 7.7 points,which decreased to 4.3 points postoperative.3 patients died of original cancer,while the other 8 patients remained alive.Conclusion The operation method of one-stage posterior approach total vertebral resection combined with bone cement infuse and screw fixation for upper thoracic metastatic tumors is safe,minimal invasive and reliable,which can obviate anterior surgery injury.