PDF(Pubmed)
Abstract：
BACKGROUND: For patients with acute paraplegia caused by spinal giant cell tumor (GCT) who require emergency decompressive surgery, there is still a lack of relevant reports on surgical options. This study is the first to present the case of an acute paraplegic patient with a thoracic spinal GCT who underwent an emergency total en bloc spondylectomy (TES). Despite tumor recurrence, three-level TES was repeated after denosumab therapy.
METHODS: A 27-year-old female patient who underwent single-level TES in an emergency presented with sudden severe back pain and acute paraplegia due to a thoracic spinal tumor. After emergency TES, the patient\'s spinal cord function recovered, and permanent paralysis was avoided. The postoperative histopathological examination revealed that the excised neoplasm was a rare GCT. Unfortunately, the tumor recurred 9 months after the first surgery. After 12 months of denosumab therapy, the tumor size was reduced, and tumor calcification. To prevent recurrent tumor progression and provide a possible cure, a three-level TES was performed again. The patient returned to an active lifestyle 1 month after the second surgery, and no recurrence of GCT was found at the last follow-up.
CONCLUSIONS: This patient with acute paraplegia underwent TES twice, including once in an emergency, and achieved good therapeutic results. TES in emergency surgery is feasible and safe when conditions permit; however, it may increase the risk of tumor recurrence.
METHODS: A 27-year-old female patient who underwent single-level TES in an emergency presented with sudden severe back pain and acute paraplegia due to a thoracic spinal tumor. After emergency TES, the patient\'s spinal cord function recovered, and permanent paralysis was avoided. The postoperative histopathological examination revealed that the excised neoplasm was a rare GCT. Unfortunately, the tumor recurred 9 months after the first surgery. After 12 months of denosumab therapy, the tumor size was reduced, and tumor calcification. To prevent recurrent tumor progression and provide a possible cure, a three-level TES was performed again. The patient returned to an active lifestyle 1 month after the second surgery, and no recurrence of GCT was found at the last follow-up.
CONCLUSIONS: This patient with acute paraplegia underwent TES twice, including once in an emergency, and achieved good therapeutic results. TES in emergency surgery is feasible and safe when conditions permit; however, it may increase the risk of tumor recurrence.
摘要：
背景：对于脊柱巨细胞瘤（GCT）引起的急性截瘫患者，需要进行紧急减压手术，目前仍缺乏有关手术选择的相关报道。这项研究是第一个介绍患有胸椎GCT的急性截瘫患者进行紧急全脊椎切除术（TES）的病例。尽管肿瘤复发，denosumab治疗后重复三级TES.
方法：一名27岁女性患者，在紧急情况下接受了单级TES，由于胸椎肿瘤，突然出现严重的背痛和急性截瘫。紧急TES后，患者的脊髓功能恢复,避免了永久性瘫痪。术后组织病理学检查显示，切除的肿瘤是罕见的GCT。不幸的是,第一次手术后9个月肿瘤复发。经过12个月的denosumab治疗，肿瘤缩小了，肿瘤钙化.为了防止肿瘤复发并提供可能的治疗方法，再次进行三级TES。患者在第二次手术后1个月恢复了积极的生活方式，末次随访时未发现GCT复发。
结论：该急性截瘫患者接受了两次TES，包括在紧急情况下,取得了良好的治疗效果。在条件允许的情况下，紧急手术中的TES是可行且安全的；但是，它可能会增加肿瘤复发的风险。
方法：一名27岁女性患者，在紧急情况下接受了单级TES，由于胸椎肿瘤，突然出现严重的背痛和急性截瘫。紧急TES后，患者的脊髓功能恢复,避免了永久性瘫痪。术后组织病理学检查显示，切除的肿瘤是罕见的GCT。不幸的是,第一次手术后9个月肿瘤复发。经过12个月的denosumab治疗，肿瘤缩小了，肿瘤钙化.为了防止肿瘤复发并提供可能的治疗方法，再次进行三级TES。患者在第二次手术后1个月恢复了积极的生活方式，末次随访时未发现GCT复发。
结论：该急性截瘫患者接受了两次TES，包括在紧急情况下,取得了良好的治疗效果。在条件允许的情况下，紧急手术中的TES是可行且安全的；但是，它可能会增加肿瘤复发的风险。
