Composite peek/carbon fiber pre-shaped rods and sublaminar bands for posterior stabilization of cervico-thoracic junction: A novel technique
| Autor: | Gisberto Evangelisti, Giuseppe Tedesco, Alessandro Gasbarrini, Riccardo Ghermandi, Valerio Pipola, Marco Girolami, Stefano Boriani, Alessandro Ricci |
|---|---|
| Přispěvatelé: | Pipola V., Boriani S., Ghermandi R., Tedesco G., Evangelisti G., Girolami M., Ricci A., Gasbarrini A. |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Novel technique Polymers medicine.medical_treatment Sublaminar bands Neurosurgical Procedures Polyethylene Glycols Benzophenones 03 medical and health sciences Fixation (surgical) 0302 clinical medicine Carbon Fiber Cervical spine Physiology (medical) Peek Humans Medicine Cervico-thoracic stabilization Proton therapy Spinal Neoplasms Particle therapy business.industry En bloc resection General Medicine Ketones Middle Aged Spine Radiation therapy Treatment Outcome Sclerosing Epithelioid Fibrosarcoma Neurology 030220 oncology & carcinogenesis Surgery Neurology (clinical) Implant Neoplasm Recurrence Local business Nuclear medicine Carbon fiber reinforced peek rod 030217 neurology & neurosurgery |
| Zdroj: | Journal of Clinical Neuroscience. 72:429-433 |
| ISSN: | 0967-5868 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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