The Spinal Stability Reconstruction for Various Surgical Stages of Tumor Lesions

Objective: To observe the clinical outcomes of various spinal reconstruction methods for spinal tumors. Methods:Twenty eight cases were included in this series, 14 males and 14 females, aged from 5 to 71 years, the means was 39.3 years. 11 cases were benign and 11 cases were malignant, the remaining 6 were metastases. Four surgical procedures were applied to various surgical stages of spinal tumor lesions:(1)vertebrectomy in 9 cases, (2)sagittal resection in 3 cases,(3)posterior arch resection in 2 cases and (4) corporectomy in 14 cases, The methods of stability reconstruction were:(1) anterior instrumentation in 3 cases,(2) posterior instrumentation in 17 cases and (3) circumferential spinal reconstruction combined with anterior and posterior instrumentation in 5 cases. Results: All patients had a pain relieve and motor function improved in 11 of 13 cases. Two giant cell tumors had local recurrence, one of them became malignant, both of them were submitted to a second curettage and resection. Two malignant cases died 9 and 12 months later, respectively. One C 5 chondrosarcoma had bone graft dislocation undergone second surgical procedure, the remaining one had recurrence of L 1 myeloma with deterioration of neurologic function. He was given second currettage and posterior stability, but there was no neurologic function improvement. The complications of instrumentation were:(1)dislocation in one nut of pedicle screw,(2)mal position of 9 pedicle screws in 4 cases. Conclusions: Strut bone graft and artificial vertebral body implant combined with anterior, posterior or circumferential instrumentation is efficacious in reconstruction of spinal stability.