One-stage posterolateral decompression and stabilization for primary and metastatic vertebral tumors in the thoracic and lumbar spine

医学 减压 椎板切除术 外科 脊柱减压 腰椎 阶段(地层学) 背痛 胸椎 腰椎 腰椎 脊髓 古生物学 替代医学 病理 精神科 生物
作者
Brian Shaw,Frederick L. Mansfield,Lawrence F. Borges
出处
期刊:Journal of Neurosurgery [Journal of Neurosurgery Publishing Group]
卷期号:70 (3): 405-410 被引量:94
标识
DOI:10.3171/jns.1989.70.3.0405
摘要

✓ During the past decade, anterior approaches to the spine have been shown to be much more effective than laminectomy for the relief of pain and neurological deficits due to vertebral metastases. Laminectomy has failed because it does not allow adequate decompression of epidural lesions anterior to the thecal sac. In an effort to combine the advantages of the posterior approach with an adequate decompression, a one-stage posterolateral decompression-stabilization procedure was performed on nine patients with thoracolumbar spine tumors. The approach has been used for decompression and stabilization after thoracolumbar burst fractures. Marked lasting improvement was seen in all six patients with preoperative neurological deficits and in four patients with severe back pain and/or radiculopathy. Three nonambulators and two marginal ambulators could walk postoperatively without assistance. Of five patients who were working preoperatively, four returned full-time to their prior occupations. Three patients had serious complications, including one early postoperative death. No patient deteriorated neurologically due to the procedure. Although the series is small, it demonstrates that adequate one-stage decompression-stabilization of spinal epidural lesions is possible via the posterolateral approach and should be considered in certain cases as an alternative to the anterior approach.
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