Thoracolumbar spine corpectomy with placement of a cage by single posterior approach: Surgical technique and results of six patients [Corpectomia da coluna toracolombar com colocação de cage por acesso único via posterior: Técnica cirúrgica e resultados de seis pacientes]
Nogueira F.M.,Servico de Neurocirurgia |
De Morais D.F.,Faculdade Medicina de Sao Jose Rio Preto |
Da Cruz Adry R.A.R.,Residentes de Neurocirurgia |
Cohen M.I.,Residentes de Neurocirurgia |
And 4 more authors.
Coluna/ Columna | Year: 2011
Objective: To evaluate retrospectively the results of a series of patients undergone thoracic or lumbar corpectomy via single posterior approach with placement of cage and segmental instrumented arthrodesis. The surgical technique performed was described. Methods: The retrospective study evaluated six patients with vertebral collapse, biomechanical instability or neurological damage caused by different etiologies. These patients showed neural decompression and received indication to perform corpectomy and circumferential reconstruction with cage being conducted exclusively by posterior approach. Results: Four patients were male and 2 female. The average age was 58 years (22-82 years) and mean follow up was 10.5 months (2-24 months). In three cases the resection was only one vertebral body and in three cases two vertebral bodies. All patients improved in neurological status and low back pain or radicular pain. The indications for surgery were three cases of spondylodiscitis, one of osteoporotic fracture, one case of metastatic tumor and one case of primary tumor. Three patients had complications requiring surgical revision; which resulted in improvement of symptoms. The complications that occurred were cerebrospinal fluid leakage, lumbar radiculopathy, wound infection, meningitis and failure of instrumentation. Conclusion: Patients submitted to corpectomy via single posterior approach showed favorable outcomes with improvement of neurological deficit or pain in all cases. This technique was efficient in the reconstruction of circumferential column avoiding the complications of the traditional anterior-posterior approach.
Lachman R.,Cedars Sinai Medical Center |
Martin K.W.,Childrens Hospital Oakland Research Institute |
Castro S.,Servico de Neuroradiologia |
Basto M.A.,Servico de Neuroradiologia |
And 2 more authors.
Journal of Pediatric Rehabilitation Medicine | Year: 2010
The mucopolysaccharidoses (MPS) represent a group of inheritable, clinically heterogeneous lysosomal storage disorders, in which progressive accumulation of glycosaminoglycans (GAGs) can affect organs and tissues all over the body. The current paper discusses the skeletal X-ray and neuroimaging findings in MPS patients, and the imaging techniques that can be used for diagnosing and monitoring abnormalities in the skeleton and central nervous system. Most MPS types show a typical radiologic expression, called dysostosis multiplex, which manifests as malformations of the skeletal system involving bones in the skull, thorax, spine, pelvis, long bones, and hands. Abnormalities of the spine and GAG deposits in the meninges surrounding the spinal cord can result in spinal cord compression, which, if untreated, can lead to compressive myelopathy. Magnetic resonance imaging (MRI) is the most powerful imaging technique for detecting spinal cord compression, but also radiography and computed tomography are useful. GAG deposits in the brain and surrounding tissues can result in brain anomalies, i.e. white matter lesions, brain atrophy, and hydrocephalus, which can be detected using MRI. Skeletal X-ray and neuroimaging findings can play an important role in diagnosis, follow-up, surgical or medical planning, and assessment of treatment response in MPS patients. There is a need for standardized procedures in evaluating and monitoring neurologic complications in these patients. © 2010 IOS Press and the authors.