Composite peek/carbon fiber pre-shaped rods and sublaminar bands for posterior stabilization of cervico-thoracic junction: A novel technique.

Autor: Pipola V; Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy. Electronic address: valeriopipola@gmail.com., Boriani S; IRCCS Istituto Ortopedico Galeazzi, Milano, Italy., Ghermandi R; Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy., Tedesco G; Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy., Evangelisti G; Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy., Girolami M; Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy., Ricci A; Department of Anesthesia-Resuscitation and Intensive Care, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy., Gasbarrini A; Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Jazyk: angličtina
Zdroj: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia [J Clin Neurosci] 2020 Feb; Vol. 72, pp. 429-433. Date of Electronic Publication: 2019 Dec 27.
DOI: 10.1016/j.jocn.2019.12.035
Abstrakt: The combination of surgery plus radiotherapy is a valid treatment option when en bloc resection with wide margins is not feasible. The aim of this paper is to show a novel technique for fixation of cervico-thoracic junction with carbon fiber reinforced peek pre-shaped rods with sublaminar bands in order to guarantee cervical spine stability and particle therapy efficacy. A 42 years-old man with a Sclerosing Epithelioid Fibrosarcoma (SEF) arising from C7, involving the right latero-cervical region from C5 to the apex of the right lung, underwent an en bloc resection with a double approach (anterior plus posterior). Fixation of cervical spine was achieved with composite PEEK/carbon fiber rods connected to C4 and T2 laminae with sublaminar bands. After surgery, the patient received 9 cycles of chemotherapy (cisplatin, etoposide and adriamycin) and proton therapy. At 2 years follow-up, no local recurrence was detected with implant stability demonstrating no mechanical failure. The main issues related to this case were: planning en bloc resection able to achieve an Enneking appropriate margin; incorporate in the decision making process the functional loss related to the sacrifice of neurological structures infiltrated by the tumor; establish a therapeutic strategy that included, in addition to surgery, adjuvant chemotherapy and radiotherapy for improving local and systemic control; stabilize with implants that do not interfere with accelerated particle radiotherapy.
(Copyright © 2019 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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