One-Stage Vertebral Reconstruction Combined with Posterior Instrumentation by Posterolateral Approach for Spinal Metastasis.

Jang, Ji Soo; Kim, Jin Kuk; Park, Woo Min; Heon, Yoo; Rhee, Chang Hoon; Lee, Seung Hoon

Original Article

Journal of Korean Neurosurgical Society 1999;28(10): 1485-1490.

Ji Soo Jang, Jin Kuk Kim, Woo Min Park, Yoo Heon, Chang Hoon Rhee, Seung Hoon Lee

One-Stage Vertebral Reconstruction Combined with Posterior Instrumentation by Posterolateral Approach for Spinal Metastasis

ABSTRACT

The authors present a series of 12 patients who underwent one-stage spondylectomy, vertebral reconstruction, posterior segmental stabilization for malignant metastatic disease. Major indication for this approach includes three column involvement or untolerable thoracotomy. This operative method involved the spondylectomy via a bilateral transpedicular or unilateral extracavitary approach, vertebral body reconstruction with methlymethacrylate (MMA), and posterior stabilization with sublaminar wiring in one stage. Postoperatively, all patients improved neurologically. Average neurologic improvement was 1.5 Frankel grade. Pain relief was obtained in all patients. Recovery of sphincter change was obtained 7(88%) of the 8 patients. One patient died postoperatively due to pneumonia. Spinal alignment was maintained in all. The major advantage of this approach is that circumferential decompression of the spine and stabilization can be obtained safely by one stage.

Key Words: Spinal metastasis; One-stage spondylectomy; Vertebral reconstruction; Posterior stabilization