Application of bone cement in the posterior approach surgical treatment for metastatic tumor of the thoracolumbar spine

English Keywords:Metastatic tumor  Thoracic vertebra  Lumbar vertebra  Bone cement  Surgical treatment  Posterior approach

English Abstract:

  【Abstract】 Objective：To explore the clinic effects of the bone cement utilized in the posterior approach surgical treatment of the thoracic and lumbar spinal metastatic tumor.Method：26 patients with the thoracolumbar spinal metastatic tumors who underwent posterior approach surgical treatment from March 2004 to December 2008 were reviewed retrospectively.There were lung carcinoma in 9 cases，breast carcinoma in 7 cases，hepatocarcinoma in 4 cases，prostate carcinoma in 2 cases，kidney carcinoma in 1 case，and 3 cases with unknown origin.Tumor involved single vertebral body in 17 cases，two vertebral bodies in 9 cases.23 patients complained of various back pain，neurofunction classification based on Frankel grading system presented B in 6，C in 7，D in 11 and E in 2.The multilevel posterior pedicle screw instrumentation combined with bone cement were performed on all patients to reconstruct the spine stability.15 vertebral bodies were packed by bone cement，9 vertebral bodies were reconstructed with bone cement after total spondylectomy，11 vertebral bodies were treated by vertebroplasty.10 patients with osteoporosis underwent augmentation of pedicle screw path by bone cement at the same time.Result：There was no neurofunction injury duo to heating effect from bone cement during the operation，24 patients were followed up 3 to 42 months with a mean of 18.2 months After the operation，the pain was relieved in 20 cases，the nerve compression symptoms were improved in 17 cases.The internal fixation was firmly seated with no bone coment sinked，no vertebra body corruption and no pedicel break.15 cases died during the follow-up.Conclusion：During the posterior approach surgical treatment of thoracolumbar spinal metastatic tumor，based on the patient general condition，life expectancy，neurological deterioration，tumor type and location within spine，and quality of the vertebra，proper use of bone cement can minimize surgical injury and increase living quality of the patients as bone cement has unique physicochemical characteristics.