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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 11/2019

01-11-2019 | Computed Tomography | Orthopaedic Surgery

Post-carbon-ion radiotherapy vertebral pathological fractures in upper cervical primary malignant spinal tumors treated by occipito-cervical fusion

Authors: Satoshi Baba, Yoshihiro Matsumoto, Kenichi Kawaguchi, Keiichiro Iida, Hirokazu Saiwai, Seiji Okada, Akira Matsunobu, Yoshiyuki Shioyama, Yasuharu Nakashima

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 11/2019

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Abstract

Purpose

To describe the characteristic features of post-carbon-ion radiotherapy (CIRT) vertebral pathological fractures (VPFs) in upper cervical primary malignant spinal tumors (PMSTs) treated by occipito-cervical (OC) fusion.

Methods

OC fusion was performed for three consecutive patients with post-CIRT VPFs. The clinical results and imaging findings, including bone single-photon emission computed tomography (SPECT)/CT were prospectively collected.

Results

No surgery-related wound complication and surgical site infection were noted. One patient experienced re-fracture and displacement of dens with the loosening of occipital screws and was treated by posterior revision surgery. At the final follow-up, all patients were alive without evidence of disease, and the solid OC fusion was confirmed. Bone SPECT/CT clearly revealed the effect of CIRT on bone turnover in the irradiated field.

Conclusion

The OC fusion with autologous bone grafts was a reliable option for the treatment of post-CIRT VPCs in the patients with upper cervical PMSTs. In addition, evaluation of the bone turnover at the irradiated field by bone SPECT/CT would help surgeons select an effective plan of care, such as fusion level and postoperative care.
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Metadata
Title
Post-carbon-ion radiotherapy vertebral pathological fractures in upper cervical primary malignant spinal tumors treated by occipito-cervical fusion
Authors
Satoshi Baba
Yoshihiro Matsumoto
Kenichi Kawaguchi
Keiichiro Iida
Hirokazu Saiwai
Seiji Okada
Akira Matsunobu
Yoshiyuki Shioyama
Yasuharu Nakashima
Publication date
01-11-2019
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 11/2019
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-019-03183-x

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