Objective: To investigate the feasibility and clinical significance of single-stage posterior vertebrectomy with reconstruction for the treatment of spinal tumor.
Methods: Twenty-six consecutive patients with spinal tumor, 5 with giant cell tumor, 6 with metastatic tumor of breast cancer, 8 with metastatic tumor of lung cancer, 2 with plasmacytoma, 3 with metastatic tumor of renal carcinoma, and 2 with lymphoma, 12 males and 14 females, aged 49 (20-74), underwent single-stage posterior vertebrectomy through bilateral transpedicular route via posterior midline approach. Anterior column reconstruction was performed with non-expandable cages. Anterior and posterolateral arthrodeses were achieved using autograft. Posterior segmental instrumentation was used in all cases. Follow-up was conducted for 10-48 months.
Results: The mean operative time was 4.5 hours and the mean blood loss was 1600 ml. Sagittal deformity correction was performed for the four patients with preoperative kyphosis. 15 patients were neurologically intact preoperatively (at Frankel grade E) and remained intact postoperatively. 11 patients with functional disorders of spinal cord or nerves (Frankel grade D) preoperatively showed improvement to Frankel grade E postoperatively. Local pain disappeared in 19 patients and reduced in 7 patients.
Conclusion: A safe and effective technique for the treatment of spinal tumor, single-stage posterior vertebrectomy with reconstruction fully decompresses the neurological structures, corrects kyphosis, and achieves early weight-bearing, thus significantly improving the quality of life of the patients with spinal tumor.