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.
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。