后路联合胸椎椎间孔后壁开窗和脊柱重建技术治疗复杂胸椎椎间孔病变

Posterior approach combined with thoracic intervertebral foramen posterior wall opening and spinal reconstruction for complex thoracic intervertebral foramen lesions

目的评估后路联合胸椎椎间孔后壁开窗和脊柱重建技术治疗复杂胸椎椎间孔病变的可行性和安全性。方法对12例复杂胸椎椎间孔病变患者,采用后路联合胸椎椎间孔后壁开窗切除椎间孔病变,钉棒内固定技术(SRFT)重建脊椎稳定性。三维螺旋CT和MRI观察胸椎椎间孔病变切除程度及植骨融合脊椎内固定情况。结果 12例患者均通过该入路成功切除病变,切口一期愈合。12例患者均获随访,随访时间11~29(19.6±5.8)个月。根据三维螺旋CT和MRI复查,植骨一期融合,未发现病变复发和断钉、断棒、固定器械松弛或脊柱不稳定。结论后路联合胸椎椎间孔后壁开窗和SRFT重建脊椎稳定性是治疗复杂胸椎椎间孔内病变的有效、可靠的方法,具有较好的脊柱稳定性。

Objective To evaluate safety and feasibility of posterior approach combined with thoracic intervertebral foramen posterior wall opening and spinal reconstruction for complex thoracic intervertebral foramen lesions. Methods Twelve patients presenting with complex thoracic intervertebral foramen（TIF） lesions were reviewed retrospectively. These TIF lesions were removed with posterior approach combined with TIF posterior wall opening, and spine reconstruction was performed using the screw and rod fixation technique（SRFT）. The removal of TIF lesions and spinal reconstruction was investigated with three-dimensional CT and MRI. Results The TIF lesions in all patients were successfully removed with this approach. All wounds healed primarily. Patients were followed up for 11~29 months with average of 19.6±5.8 months. Three-dimensional CT and MRI showed that all grafts were I period fusion. There were no recurrence of TIF lesions and no fixation loosening, breaking or spinal instability. Conclusion A posterior approach combined with TIF posterior wall opening and spinal reconstruction is a rapid,effective and reliable method in the treatment of complex TIF lesions. This technique can provide total lesion resection with reconstructing spinal stability.