Single-stage multi-level assemble design incorporating ribs and chest wall reconstruction after en bloc resection of spinal tumour.

Int Orthop. 2018 Feb 05;:

Authors: Xiao J, He S, Jiao J, Wan W, Xu W, Zhang D, Liu W, Zhong N, Liu T, Wei H, Yang X

Summary
PURPOSE: Multi-level reconstruction incorporating the chest wall and ribs is technically demanding after multi-segmental complete en bloc spondylectomy (TES) of thoracic spinal tumours. Few surgical methods are reported for efficient reconstruction. A novel and easy technical reconstruction by way of posterior-lateral strategy was introduced to resolve the intensive chest wall defect and forestall occurrences of extreme respiratory dysfunctions after performing TES. The preliminary outcomes of surgical procedure have been reviewed.
METHODS: Multi-level TES was carried out for 5 sufferers with main or recurrent thoracic spinal malignancies by way of posterior-lateral strategy. The concerned ribs and chest wall have been eliminated to realize tumour-free margin. Then titanium mesh with allograft bone and pedicle screw-rod system have been adopted for the circumferential spinal reconstruction routinely. Titanium rods have been modified accordingly to connect to the screw-rod system proximally, and the distal finish of rods was dynamically inserted into the ribs.
RESULTS: The imply surgical procedure time was 6.7 hours (vary 5-Eight), with the typical blood lack of 3260 ml (vary 2300-4500). No extreme neurological problems have been reported whereas three sufferers had complaints of slight numbness of chest pores and skin (no. 1, three, and 5). No extreme respiratory problems occurred throughout peri-operative interval. No implant failure and no native recurrence or distant metastases have been noticed with a median follow-up of 12.5 months.
CONCLUSIONS: The one-stage reconstructions incorporating backbone and chest wall are easy and straightforward to carry out. The preliminary outcomes of co-reconstructions are promising and beneficial. Extra research and longer follow-up are required to validate this method.

PMID: 29404670 [PubMed – as supplied by publisher]