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Emergency (Ad Hoc) Stabilization of The Anterior Vertebral Column with Two Combined Synex Implants After Two-Level Vertebrectomy L2 and L3. Case Report and the Technique Description | Abstract
ISSN: 2165-7939

Journal of Spine
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Case Report

Emergency (Ad Hoc) Stabilization of The Anterior Vertebral Column with Two Combined Synex Implants After Two-Level Vertebrectomy L2 and L3. Case Report and the Technique Description

Jarosław Andrychowski1,2*, Paweł Dąbe3, Zbigniew Czernicki1,2 and Piotr Jasielski1
1Department of Neurosurgery, Mossakowski Medical Research Centre, Polish Academy of Sciences, Bielański Hospital, Cegłowska Str 80, 01-809 Warsaw, Poland
2Department of Neurosurgery, II-nd Faculty, Medical University of Warsaw, Bielański Hospital, Cegłowska Str 80, 01-809 Warsaw, Poland
3Department of Vascular Surgery, Medical Postgraduate Faculty, Bielański Hospital, Cegłowska Str 80, 01-809 Warsaw, Poland
Corresponding Author : Jarosław Andrychowski
Department of Neurosurgery
Mossakowski Medical Research Centre
Polish Academy of Sciences
Bielański Hospital, Cegłowska Str 80
01-809 Warsaw, Poland
Tel: (0048)225690490
Fax: (0048)228350005
E-mail: [email protected]
Received November 13, 2011; Accepted December 12, 2011; Published December 16, 2011
Citation: Andrychowski J, Dabek P, Czernicki Z, Jasielski P (2012) Emergency (Ad Hoc) Stabilization of The Anterior Vertebral Column with Two Combined Synex Implants After Two-Level Vertebrectomy L2 and L3. Case Report and the Technique Description. J Spine 1:101. doi:10.4172/2165-7939.1000101
Copyright: © 2012 Andrychowski J, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Case report of the patient who underwent two-stage surgical treatment due to pathological fracture of vertebral column (L3 due neoplasm infiltration) in the course of kidney cancer is presented. Decompression of vertebral canal from the posterior approach in lumbar segment (L3 and partially L2) was performed due to sudden neurological functions impairment. Lumbar segment of vertebral column was stabilized via the transpedicular approach with Clix system (Synthes). In the second stage anterior approach via laparotomy was performed, urological team excised the kidney tumour, the next team vascular surgeon and neurosurgeon, performed resection of L3 and L2 vertebras (L3 was pathological fractured and compressed of cauda equine structures, L2 was partially cancer infiltrated). During the attempt of anterior column stabilization it was found, that the longest vertebral prosthesis of Synex set (Synthes) is shorter than the distance measured between L1 and L4 vertebras for about 5-7 mm.

The anterior column stabilizing set consisting of two vertebral prostheses from Synex set connected permanently with the crosspieces – crossbars rods used in transpedicular stabilizations was constructed ad hoc using the available elements. Stable set ready to use was obtained. After preparation, the set was placed between the vertebral bodies, than extended .Control X -ray revealed its appropriate location and supporting function. The ad hoc formed set of such type could be only used in normal transpedicular posterior stabilization of the vertebral column, Distance between the vertebral bodies after the resection probably resulted from the constitutional patient traits (app. 200cm tall) The patient was assessed in Out Patient Clinic, his life was improved after the operation, was independently, Lovett score 4/ 5. After the operation was performed four courses of chemotherapy during 18 months.

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