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. 2018;26(6):406-410.
doi: 10.1590/1413-785220182606180916.

FOUR-LEVEL EN BLOC VERTEBRECTOMY: A NOVEL TECHNIQUE AND LITERATURE REVIEW

Douglas Kenji Narazaki  1 , Lucas P Higino  1 , William Gemio Jacobsen Teixeira  1 , Ivan Dias da Rocha  1 , Alexandre Fogaça Cristante  2 , Tarcísio Eloy Pessoa de Barros  2
Affiliations

FOUR-LEVEL EN BLOC VERTEBRECTOMY: A NOVEL TECHNIQUE AND LITERATURE REVIEW

Douglas Kenji Narazaki et al. Acta Ortop Bras. 2018.

Abstract
in English, Portuguese

Objective: To demonstrate a novel technique for multilevel en bloc post-vertebrectomy reconstruction.

Methods: A novel technique for en bloc multiple post-vertebrectomy reconstruction was used in a patient presenting for curative resection of Ewing's Sarcoma at the oncology center of a public university hospital.

Results: The procedure described was feasible for en bloc resection of the four vertebrae. The reconstruction was acceptable and satisfactory in terms of mechanical stability and was without any neurological sequelae in the patient.

Conclusion: The use of an allograft with a locked intramedullary nail was an adequate solution for reconstructing the anterior and medial spines after multilevel vertebrectomy. In addition, the association of four intramedullary nails provided stability to the reconstruction. Immediate benefits of the technique compared to other commonly used techniques were shorter hospitalization times and reduced surgical morbidity. Level of Evidence V, Clinical study of a new surgical technique and a literature review.

Objetivo: Demonstrar uma nova técnica de reconstrução por vertebrectomia em bloco multinível.

Métodos: Descrição de uma reconstrução pós-vertebrectomia em bloco multinível, em paciente tratado num hospital oncológico público universitário, com indicação de ressecção curativa de sarcoma de Ewing.

Resultados: O procedimento proposto foi viável para a ressecção em bloco de quatro vértebras e a reconstrução foi aceitável e satisfatória em termos de estabilidade mecânica, sem causar dano neurológico ao paciente.

Conclusão: O uso de aloenxerto com parafuso intramedular bloqueado é uma solução adequada para a reconstrução da coluna anterior e medial após vertebrectomias multiníveis. Além disso, a associação de quatro parafusos intramedulares dá estabilidade à reconstrução. Benefícios imediatos da técnica são o tempo de hospitalização mais curto e a redução da morbidade cirúrgica, em comparação com outras técnicas, comumente utilizadas. Nível de Evidência V, Estudo clínico de nova técnica cirúrgica e revisão da literatura.

Keywords: Orthopedics; Reconstructive Surgical Procedures; Spinal Neoplasms; Spine; Thoracic Surgery.

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Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1
Figure 1. Preoperative scintigraphy (A) and magnetic resonance imaging (MRI) (B to F) of the patient with Ewing's Sarcoma.
Figure 2
Figure 2. Operative imaging of the patient with Ewing's Sarcoma: operative planning (A-J), photographs of the surgery (K-Q) and photographs of the excised pieces (R, S).
Figure 3
Figure 3. Postoperative radiographs (A-D) and magnetic resonance imaging (MRI) (5-6) of the patient with Ewing's Sarcoma.
See this image and copyright information in PMC

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