上位胸椎転移性腫瘍に対する sternum-splitting approach の経験

概要

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We treated a 61-year-old man with metastatic lesions in the first and second thoracic vertebrae. The histological diagnosis was papillary-type thyroid carcinoma. Before resection of the tumor, external fixation with a halo vest and posterior fixation with titanium rods was carried out. An oblique skin incision was made along the anterior border of the right sternocleidomastoid muscle to the sternal notch, and continued along the midline of the sternum. After sternotomy, the right common carotid artery, trachea, esophagus, bracheocephalic vein and aortic arch were retracted. This process permits exposure from the seventh cervical vertebra to the upper border of the third thoracic vertebra. When removing the tumor, bleeding occured easily, and exposure of the third thoracic vertebra was limited. Gross total removal of the tumor and iliac bone autograft were performed, but the bone graft was deviated to the right because of the inadequate exposure of the vertebra. However, the patient was ambulatory at the time of discharge. We conclude that adequate tumor removal and stabilization should be performed for patients with spinal metastasis if there is a possibility that it will improve their quality of life.
日本脊髄外科学会の論文
1998-03-30