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Assessment of spinal tumor Treatment Using Implanted 3D-Printed Vertebral Bodies with Robotic Stereotactic Radiotherapy

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The Innovation 2020年第2期1卷 8-12,7页

作者： Hongqing Zhuang Feng Wei Liang Jiang Yuxia Wang Zhongjun Liu Department of Radiation Oncology Peking University Third Hospital49 North Garden RoadHaidian DistrictBeijing 100191P.R.China Orthopedic Department Peking University Third Hospital49 North Garden RoadHaidian DistrictBeijing 100191P.R.China These authors contributed equally

To investigate the feasibility and early efficacy of 3D-printed vertebral body implantation combined with robotic radiosurgery in the treatment of spinal *** study included 14 patients with spinal tumors from December 2017 to June *** surgery,all patients were subjected to CT scan and 3D data of the corresponding vertebral segments were *** alloy formed 3D-printed vertebral body implantation and robotic stereotactic radiotherapy were performed because of the risk of postoperative residual,high risk of recovery,or recurrence after *** main outcomes included the remission of symptoms,vertebral body stability,robotic stereotactic surgical precision,and local tumor *** patients received complete and successful combination therapy,and all healed primarily without complica*** error of the coverage accuracy for robotic radiosurgery was less than 0.5 mm,and the error of the rotation angle was less than 0.5.The therapeutic toxicity was limited(mainly in grades 1–2),and adverse events were *** evaluation of vertebral body stability and histocompatibility for all patients met the postoperative clinical *** patients with post spinal injury,the pain symptoms were reduced or disappeared(93%),and nerve function was improved or even recovered after treatment(100%).During our follow-up period,most tumors were locally well controlled(93%).3D-printed vertebral body implantation combined with robotic radiosurgery may offer a new treatment of spinal *** clinical trial registry:ChiCTR-ONN-17013946.

关键词： 3D-PRINTED TECHNOLOGY spinal tumor VERTEBRAL BODY IMPLANTATION ROBOTIC STEREOTACTIC RADIOTHERAPY

Arachnoiditis Ossificans Mimicking spinal Intradural Extramedullary tumor: A Case Report and Review of the Literature

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Open Journal of Modern Neurosurgery 2021年第3期11卷 157-163页

作者： Yao Christian Hugues Dokponou Inas El Kacemi Fernand Nathan Imoumby Franck Loukou Kouakou Sofia El Akroud Miloud Gazzaz Mohammed V Military Teaching Hospital Rabat Morocco Faculty of Medicine and Pharmacy Mohammed V University Rabat Morocco

Arachnoiditis ossificans is an intradural extramedullary lesion resulting from an unusual chronic meningeal inflammatory process and it is thought to be the sequela of end-stage adhesive arachnoiditis secondary to surgery, trauma, arachnoid hemorrhage, meningeal irritation, myelography (particularly oil-based contrast agents), and spinal anesthesia. The spinal arachnoiditis ossificans may be silent or cause a variety of symptoms depending on its location and uncommonly happen to cause spinal cord compression. Very little attention has been paid to the management and outcome of this rare condition in the neurosurgical reem. We report the case of a 45 years old man admitted with L1 - L2 arachnoiditis ossificans revealed by polyradiculopathy on incomplete cauda equina syndrome mimicking spinal canal tumors. The patient underwent surgery and we performed the laminectomy of L1 - L2, total resection of the lesion, followed by a complete remission of the hemiparesis after three months of kinesitherapy nursing.

关键词： Management Outcome Arachnoiditis Ossificans spinal tumor Case Report

Single-stage Posterior Spondylectomy, Circumferential Decompression and Reconstruction Using Mesh Cage for spinal tumors

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Chinese Medical Sciences Journal 2009年第3期24卷 172-177页

作者： Yong Zhu Hong Zhao Giu-xing Qiu Jian-guo Zhang Ye Tian Shu-gang Li Suo-mao Yuan Department of Orthopedics Peking Union Medical College Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100730 China

Objective To explore the feasibility and clinical results of circumferential decompression and three column reconstruction through single-stage posterior transpedicular approach for spinal tumor treatment. Methods Totally, 24 patients with spinal tumor underwent tumor resection and spinal reconstruc tion through single-stage posterior transpedicular approach. Preoperatively, according to the Frankel classification, 12 patients were grade E, 9 grade D, and 3 grade C. Anterior column was reconstructed with non-expandable titanium cages. Posterior segmental instrumentation was used to maintain the stability of spine in all cases. Anterior and posterolateral fusion was performed with autograft and allogenic bone. The following data were followed up in these patients: deformity angle, local recurrence, neurological function, and spinal bony fusion. Results The average operating time and blood loss was 5.6 hours and 3 400 ml respectively. No intraoperative and postoperative complications were observed in this group. Postoperatively, 21 patients were Frankel grade E, 2 grade D, and 1 grade C. Four patients reported significant functional restoration and twenty patients reported complete resolution of pain. At follow-up (range, 6-42 months), implant failure or recurrent neurological symptoms was not found. Conclusions The tumor resection and spinal reconstruction through single-stage posterior transpedicular approach is a safe and effective technique for the treatment of spinal tumor. It can fully decompress the neurological structures, correct the kyphosis, and achieve early weight-bearing. This technique can improve life quality for the patients with spinal tumor.

关键词： spinal tumor vertebrectomy spinal reconstruction

Plexiform neurofibroma of the cauda equina with follow-up of 10 years:A case report

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World Journal of Clinical Cases 2022年第14期10卷 4519-4527页

作者： Zilvinas Chomanskis Raimondas Juskys Saulius Cepkus Justyna Dulko Vaiva Hendrixson Osvaldas Ruksenas Saulius Rocka Department of Neurology and Neurosurgery Institute of Clinical MedicineFaculty of MedicineVilnius UniversityVilnius 03104Lithuania Anatomy Histology and Anthropology DepartmentVilnius UniversityFaculty of MedicineVilnius 03104Lithuania Department of Neurosurgery Republican Vilnius University HospitalVilnius 04130Lithuania Faculty of Medicine Vilnius UniversityVilnius 03104Lithuania Institute of Biomedicine Faculty of MedicineVilnius UniversityVilnius 03104Lithuania Institute of Biosciences Life Sciences CentreVilnius UniversityVilnius 10257Lithuania

BACKGROUND Plexiform neurofibromas are extremely rarely found in the region of cauda equina and can pose a significant challenge in the diagnostic and management *** our knowledge,only 7 cases of cauda equina neurofibromatosis(CENF)have been reported *** SUMMARY We describe a case of a 55-year-old man with a 10 years history of progressive lower extremities weakness and bladder *** presenting,patient was misdiagnosed with idiopathic *** spine MRI revealed a tortuous tumorous masses in the cauda equina region,extending through the Th12-L4 *** patient underwent Th12-L3 Laminectomy with *** the operation,the most enlarged electroneurographically silent nerve root was resected,anticipating inadequate decompression if nerve root was *** patient’s neurological condition improved post-operatively,but urinary retention became the major *** provide a follow-up period of 10 *** this time,the patient’s condition progressively worsened despite extensive *** consequent MRI scans showed progressive enlargement of cauda equina roots and increasing lumbar stenosis,predominantly affecting L3-L4 *** the follow-up 8 years after the operation,the patient complained of worsening lower extremities sensorimotor function and neurogenic *** MRI revealed lumbar spine stenosis at the level of L3-L4,requiring further *** patient underwent a second surgery involving L4-L5 Laminectomy with duraplasty and L2-L5 transpedicular *** post-operative period was *** follow-up 18 mo after the second surgery revealed substantial improvement in patient’s *** CENF should be kept in mind during the differential diagnostic work-up for *** with an extensive decompression,duraplasty and primary spinal fixation represents a rational approach to achieve a sustained symptomatic improvement and s

关键词： Cauda equina Plexiform neurofibroma Neurofibromatosis type I Spine spinal tumor Case report

Lumbar disc sequestration mimicking a tumor:Report of four cases and a literature review

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World Journal of Clinical Cases 2022年第9期10卷 2883-2894页

作者： Sheng-Tang Li Tao Zhang Xue-Wen Shi Hua Liu Cheng-Wei Yang Ping Zhen Song-Kai Li Department of Spine Surgery The 940^(th) Hospital of Joint Logistics Support force of Chinese People’s LiberationLanzhou 730050Gansu ProvinceChina The Second Hospital of Lanzhou University Lanzhou 730000Gansu ProvinceChina Clinical Medical College Ningxia Medical UniversityYinchuan 750000Ningxia Hui Autonomous RegionChina

BACKGROUND Disc herniation refers to the displacement of disc material beyond its anatomical *** sequestration is defined as migration of the herniated disc fragment into the epidural space,completely separating it from the parent *** fragment can move in upward,inferior,and lateral directions,which often causes low back pain and discomfort,abnormal sensation,and movement of lower *** free disc fragments detached from the parent disc often mimic spinal *** like lumbar disc herniation can cause clinical symptoms similar to spinal tumors,such as lumbar soreness,pain,numbness and weakness of lower limbs,radiation pain of lower limbs,*** is usually necessary to diagnose the disease according to the doctor’s clinical experience,and make preliminary diagnosis and differential diagnosis with the help of magnetic resonance imaging(MRI)and contrast-enhanced ***,pathological examination is the gold standard that distinguishes tumoral from non-tumoral *** report four cases of disc herniation mimicking a tumor,and all the pathological results were intervertebral disc *** SUMMARY The first case was a 71-year-old man with low back pain accompanied by left lower extremity radiating pain for 1 year,with exacerbation over the last 2 *** admission,MRI revealed a circular T2-hypointense lesion in the spinal canal of the L4 vertebral segment,with enhancement on contrast-enhanced MRI suggesting *** second case was a 74-year-old man with pain in both knees associated with movement limitation for 3 years,with exacerbation over the last 3 *** revealed an oval T2-hyperintense lesion in the spinal canal at the L4–5 level,with obvious peripheral enhancement on contrast-enhanced ***,neurilemmoma was *** third case was a 53-year-old man who presented with numbness and weakness of the lumbar spine and right lower extremity for 2 *** revealed a round T2-hyperintense lesion in the spinal canal at the L4–5 le

关键词： Disc herniation Disc sequestration Mimicking tumor spinal tumor Surgery Case reports

Giant schwannoma of thoracic vertebra: A case report

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World Journal of Clinical Cases 2021年第36期9卷 11448-11456页

作者： Yu Zhou Chao-Zong Liu Shan-Yong Zhang Hao-Yu Wang Swastina Nath Varma Lan-Qing Cao Ting-Ting Hou Xin Li Bao-Jin Yao College of Traditional Chinese Medicine Changchun University of Chinese MedicineChangchun 130000Jilin ProvinceChina Division of Surgery and Interventional Science University College LondonRoyal National Orthopaedic HospitalLondon Stanmore HA74LPUnited Kingdom Department of spinal Surgery The Second Affiliated Hospital of Jilin UniversityChangchun 130000Jilin ProvinceChina Department of Pathology The Second Affiliated Hospital of Jilin UniversityChangchun 130041Jilin ProvinceChina Jilin Ginseng Academy Changchun University of Chinese MedicineChangchun 130000Jilin ProvinceChina

BACKGROUND It is relatively rare for schwannomas to invade bone,but it is very rare for a large mass to form concurrently in the paravertebral *** resection is the only effective *** of the extensive tumor involvement and the many important surrounding structures,the tumor needs to be fully *** of the tumors are completely removed by posterior combined open-heart surgery to relieve spinal cord compression,restore the stability of the spine and maximize the recovery of nerve and spinal cord *** main objective of this article is to present a schwannoma that had invaded the T5 and T6 vertebral bodies and formed a large paravertebral mass with simultaneous invasion of the spinal canal and compression of the spinal *** SUMMARY A 40-year-old female suffered from intermittent chest and back pain for 8 *** tomography and magnetic resonance imaging scans showed a paravertebral tumor of approximately 86 mm×109 mm×116 mm,where the adjacent T5 and T6 vertebral bodies were invaded by the tumor,the right intervertebral foramen was enlarged,and the tumor had invaded the spinal canal to compress the thoracic *** preoperative puncture biopsy diagnosed a benign *** resection of the tumor was achieved by a two-step *** the first step,the thoracic surgeon adopted a lateral approach to separate the thoracic tumor from the *** the second step,a spine surgeon performed a posterior midline approach to dissect the tumor from the vertebral junction through removal of the tumor from the posterior side and further resection of the entire T5 and T6 vertebral *** large bone defect was reconstructed with titanium mesh,and the posterior root arch was *** to the large amount of intraoperative bleeding,we performed tumor angioembolization before surgery to reduce and avoid large intraoperative *** postoperative diagnosis of benign schwannoma was confirmed by histochemical exam

关键词： Giant schwannoma Neurilemmoma spinal tumor Surgery Case report

spinal giant cell-rich osteosarcoma-diagnostic dilemma and treatment strategy:A case report

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World Journal of Clinical Cases 2022年第21期10卷 7565-7570页

作者： Chen-Sheng Tseng Chia-En Wong Chi-Chen Huang Hao-Hsiang Hsu Jung-Shun Lee Po-Hsuan Lee Section of Neurosurgery Department of SurgeryNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainan 704Taiwan Department of Cell Biology and Anatomy College of MedicineNational Cheng Kung UniversityTainan 701Taiwan Institute of Basic Medical Sciences College of MedicineNational Cheng Kung UniversityTainan 701Taiwan

BACKGROUND Giant cell-rich osteosarcoma(GCRO) is a rare histological variant of osteosarcoma. spinal GCROs are extremely rare, with challenging diagnosis and management. Herein, we present a case of spinal GCRO at T2, which was not diagnosed in initial biopsy but after T2 corpectomy. We detailed the clinical course, management strategy, and outcome after a 4-year *** SUMMARY A 17-year-old female patient presented with back pain followed by ascending paresthesia. spinal computed tomography(CT) and magnetic resonance imaging(MRI) revealed a collapsed T2 vertebra with an enhancing osteolytic mass. CTguided biopsy showed inconclusive morphology. Pathology from T2 corpectomy revealed GCRO. The patient subsequently received neoadjuvant chemotherapy followed by salvage operation of T2 costotransversectomy with grossly-total resection adjuvant chemoradiation. Upon treatment completion, she had complete GCRO remission. The 4-year follow-up spinal MRI showed no tumor *** spinal GCRO poses unique challenges in obtaining sufficient tissue diagnosis and complete surgical removal. However, long-term local control of spinal GCRO is possible following complete resection and adjuvant chemoradiation.

关键词： Giant cell-rich osteosarcoma Giant cell tumor Osteosarcoma spinal tumor spinal osteosarcoma Case report

Hemi-semi Laminectomy Approach for the Microsurgical Treatment of spinal Schwannomas

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Chinese Medical Sciences Journal 2012年第2期27卷 96-100页

作者： Xing Su Wei Shi Qing-feng Huang Jian-hong Shen Jian Chen Department of Neurosurgery Affiliated Hospital of Nantong UniversityNantong 226001China

Objective To evaluate the safety and efficiency of hemi-semi laminectomy approach for the micro- surgical treatment of spinal schwannomas. Methods A total of 22 patients underwent hemi-semi laminectomy for the microsurgical removal of spinal schwannomas during a period of 2009 and 2011 in Affiliated Hospital of Nantong University. We ret- rospectively analyzed the clinical outcomes of these patients. Results Of them, 5 cases were diagnosed with cervical schwannomas, 9 with thoracic schwarmomas, and 8 with lumbar schwannomas. All the tumors including two dumbbell schwannomas were totally removed without major complications. Postoperatively, all patients were followed up from 6 to 36 months. The symp- toms and signs were obviously improved, and no tumor recurrence or spinal deformity occurred. Conclusion Hemi-semi laminectomy is a safe and effective method for resection of spinal schwan- nomas

关键词： spinal tumor schwannomas microsurgery laminectomy

THE DIAGNOSIS OF MAGNETIC RESONANCE IMAGING FOR spinal CAVERNOUS ANGIOMAS

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Academic Journal of Xi'an Jiaotong University 2001年第2期13卷 145-147页

作者：同志勤白斌同志超牛凤枝赵京龙李毅傅建设 Imaging Center Second Hosp. Xi' an Jiaotong Univ. Xi' an 710004 China

Objective To assess the characteristics of magnetic resonance imaging for spinal cavernous *** The examinations of plain scan and contrast enhanced scan of magnetic resonance were performed in three patients with spinal cavernous *** The focus of two cases was located in thorax segment of the spinal cord and one in lower cervical *** focuses were single and the shape of spinal cord was normal or slightly thick. MRI characteristic of spinal cavernous angiomas was just like popcorn or mulberry with a jumbled gobbet signal. Low and short T 2 signal appeared around the focus. In all cases, there were no obvious contrast enhanced signal in 2 cases and one case with moderate contrast enhanced signal. The diameter of hemorrhage was smaller than that of the spinal *** MRI has higher sensitivity and specificity in the diagnosis of spinal cavernous angioma.

关键词： angioma cavernous spinal tumor magnetic resonance imaging