Surgical treatment of thoracic vertebrae bone tumors:81 cases report

Objective: To investigate the different anterior surgical approach of thoracic vertebrae in distinct segment,the therapic effects of tumors excision procedure,reconstruction technique strategy and prognosis.Method:81 consecutive patients with thoracic vertebrae bone tumors in our hospital from Jan 1997 to May 2002 were reported.The total spondylectomy,subtotal spondylectomy,total vertebrectomy,or subtotal vertebrectomy was performed with bone graft and anterior internal fixation according to oncologic type,tumor site and involved lesion to all cases respectively.Patients with malignant or malignant-tendency bone tumors underwent postoperative chemotherapy or radiotherapy additionally.Result:The follow-up period was from 2 to 6 years.The neurological symptoms were not improved in 4 cases.Tumors recurred in 12 cases within 6~24 months after excision respectively;4 cases with malignant tumors died of metastases and system failure in 16~48 months.The effects of postoperation were satisfactory in other cases,with improvement of spinal cord neurological function by different degrees.Conclusion:The tumors nature,surgical procedure and postoperative comprehensive therapy have important effects for the prognosis.The operative approach and surgical procedure should be selected according to the tumors location and range.Anterior bone graft,cylindrical titanic mesh/artificial vertebrae and fixation are useful for reconstruction and stabilization of thoracic spine.