Post-carbon-ion radiotherapy vertebral pathological fractures in upper cervical primary malignant spinal tumors treated by occipito-cervical fusion
Post-carbon-ion radiotherapy vertebral pathological fractures in upper cervical primary malignant spinal tumors treated by occipito-cervical fusion
复制标题
枕颈融合术治疗上颈原发性脊柱恶性肿瘤碳离子放疗后椎体病理性骨折
DOI：
10.1007/s00402-019-03183-x
复制
发表时间：
2019
影响因子：
2.3
通讯作者：
Nakashima Yasuharu
中科院分区：
文献类型：
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作者：
Baba Satoshi;Matsumoto Yoshihiro;Kawaguchi Kenichi;Iida Keiichiro;Saiwai Hirokazu;Okada Seiji;Matsunobu Akira;Shioyama Yoshiyuki;Nakashima Yasuharu
目的探讨碳离子放疗（CIRT）后椎体病理性骨折（VPFs）经枕颈融合治疗上颈椎原发性恶性脊柱肿瘤（PMSTs）的特点。方法对连续3例cirt后vpf患者进行soc融合。前瞻性收集临床结果和影像学表现，包括骨单光子发射计算机断层扫描(SPECT)/CT。结果无手术相关伤口并发症及手术部位感染发生。1例患者因枕骨螺钉松动导致牙髓再骨折移位，行后路翻修手术治疗。在最后随访时，所有患者均存活，无疾病迹象，并证实了固体OC融合。骨SPECT/CT清楚地揭示了CIRT对辐照场中骨转换的影响。结论OC与自体骨移植物融合是治疗上颈pmst患者cirt后VPCs的可靠选择。此外，通过骨SPECT/CT评估辐照场下的骨转换将有助于外科医生选择有效的护理计划，如融合水平和术后护理。
PurposeTo describe the characteristic features of post-carbon-ion radiotherapy (CIRT) vertebral pathological fractures (VPFs) in upper cervical primary malignant spinal tumors (PMSTs) treated by occipito-cervical (OC) fusion.MethodsOC fusion was performed for three consecutive patients with post-CIRT VPFs. The clinical results and imaging findings, including bone single-photon emission computed tomography (SPECT)/CT were prospectively collected.ResultsNo surgery-related wound complication and surgical site infection were noted. One patient experienced re-fracture and displacement of dens with the loosening of occipital screws and was treated by posterior revision surgery. At the final follow-up, all patients were alive without evidence of disease, and the solid OC fusion was confirmed. Bone SPECT/CT clearly revealed the effect of CIRT on bone turnover in the irradiated field.ConclusionThe OC fusion with autologous bone grafts was a reliable option for the treatment of post-CIRT VPCs in the patients with upper cervical PMSTs. In addition, evaluation of the bone turnover at the irradiated field by bone SPECT/CT would help surgeons select an effective plan of care, such as fusion level and postoperative care.