Die einzeitige kombinierte Vertebrektomie bei Tumoren der Stammwirbelsäule View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1996-03-01

AUTHORS

Archibald von Strempel

ABSTRACT

Goal of SurgeryResection of tumor as complete as possible without injury to the spinal cord or nerve roots.Maintenance of stability of the spinal column.IndicationPainful instability or imminent quadriplegia due to primary and secondary malignant tumors.ContraindicationMultiple metastases, poor general health.Positioning and AnaesthesiaLateral, followed by a knee-chest position.Surgical TechniqueThrough a standard approach for a left thoracophrenotomy resection of the involved vertebra, decompression of the dural sack, insertion of an adjustable intervertebral spreader which will maintain the distance between the vertebrae and serve as replacement for the removed vertebra. After turning the patient into prone position transpedicular fixation of the vertebral segment. (Example is given for resection of the first lumbar vertebra.)Postoperative ManagementRegular control of sensory and motoric nerve function of the limbs hourly on the day of surgery and two hourly on 1. and 2. postoperative day.Removal of drains 2 to 3 days postoperatively.Pharmacological stimulation of bowels.Daily radiographic control of chest till 1 day after the removal of drains.Mobilization within 1 week without corset.Possible ComplicationsInjury to lungs, ureters, large vessels, intestines, lumbar plexus, dura, and plexus sympathici.Haemothorax, Chylothorax, Infection.ResultsBetween 1982 and 1993 thirty-seven patients underwent vertebral resection of tumors.For analysis of retrospective results refer to Tables 1 to 3.Average surgical blood loss: 2378 ml (800 to 6500).Average duration of surgery: 238 minutes (120 to 550).Complications: 2 bronchopneumonia, 2 deep infections, 2 thrombophlebitis, 3 transient mental confusion, 1 breakage of implant after 18 months. More... »

PAGES

43-54

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/bf02510294

DOI

http://dx.doi.org/10.1007/bf02510294

DIMENSIONS

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