Surgical treatment of upper thoracic spinal tumor using the modified Sundaresan's method
- VernacularTitle:改良Sundaresan法治疗上胸椎肿瘤
- Author:
Xiaojian YE
;
Lianshun JIA
;
Wen YUAN
- Publication Type:Journal Article
- Keywords:
Thoracic vertebrae;
Spinal neoplasms;
Orthopedic procedures
- From:
Chinese Journal of Orthopaedics
2001;0(08):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effectiveness of modified Sundaresans method, including exposure through the incision involving both of the sternoclavicular joint and lower cervical region with sternum retention, in the treatment for upper thoracic spinal tumor. Methods From January 1999 to October 2003, 14 patients, 9 males and 5 females, aged from 26 to 65 years with a mean of 43 years underwent the modified Sundaresans procedure. The anterior cervico-thoracic incision was made, the medial part of clavicle close to the sternoclavicular joint was removed. After the exposure of the tumor, the involved vertebral body and contiguous discs were resected, the spinal cord was decompressed, then followed by implanting part of resected clavicle or titanium mesh with an anterior locking plate system. Neurological status was graded according to Frankel grading system. Results The duration of follow-up ranged from 6 months to 2 years with an average of 10 months. This approach displayed the upper thoracic region clearly for removal of the tumor and internal fixation,in avoiding the neurological injury. All patients had their neurological improvement at different level. According to Frankel grading system, one patient improved from grade A pre-operation to B post-operation, while another patient from B to D. Of 2 cases with grade C before operation, one improved to D and the other to E. Of 4 patients with grade D, 2 improved to E, while the other 2 left unchanged. There were 6 cases keeping the same grade before and after operation. Resection of sternoclavicular joint almost had no effect on the movement of shoulder. The abduction of the shoulder joint in 14 patients from 90?-130?(average, 125?) preoperatively became 80?-120?(average, 110?) postoperatively. Conclusion The modified Sundaresans method for the upper thoracic tumors has many advantages, such as satisfactory outcome, less invasion and no loss of the shoulder function. It is especially indicated to the tumors, where the spinal compression is located anteriorly.
