Takahiro Onoki1, Haruo Kanno2, Toshimi Aizawa1, Ko Hashimoto1, Eiji Itoi1, Hiroshi Ozawa3. 1. Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan. 2. Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan. kanno-h@isis.ocn.ne.jp. 3. Department of Orthopaedic Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1, Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan.
Abstract
PURPOSE: Primary osseous hemangiopericytoma (HPC) of the spine is exceedingly rare. HPC has malignant potential and has the capacity for metastasis and local recurrence. We herein present the first case of recurrent primary osseous HPC in the thoracic spine that was successfully treated by total spondylectomy at three vertebral levels and spinal reconstruction. METHODS: We performed a two-stage operation for recurrent HPC using anterior and posterior approaches at the T5-T7 vertebrae. The preoperative embolization of the tumor was performed to prevent massive intraoperative bleeding. Then, total spondylectomy was performed (T5-T7) to resect the tumor. Anterior spinal reconstruction and posterior instrumentation were performed, with abundant bone autograft and allograft used to achieve sufficient boney fusion following the removal of the tumor. RESULTS: At 2 years after surgery, the patient had made a sufficient recovery from his symptoms. The bone union was complete without tumor recurrence or implant failure. CONCLUSIONS: Total spondylectomy and spinal reconstruction with instrumentation might be useful for performing the safe and adequate excision of recurrent HPC of the spine. However, patients should be closely monitored to detect local recurrence and the malignant degeneration of the tumor after surgery.
PURPOSE:Primary osseous hemangiopericytoma (HPC) of the spine is exceedingly rare. HPC has malignant potential and has the capacity for metastasis and local recurrence. We herein present the first case of recurrent primary osseous HPC in the thoracic spine that was successfully treated by total spondylectomy at three vertebral levels and spinal reconstruction. METHODS: We performed a two-stage operation for recurrent HPC using anterior and posterior approaches at the T5-T7 vertebrae. The preoperative embolization of the tumor was performed to prevent massive intraoperative bleeding. Then, total spondylectomy was performed (T5-T7) to resect the tumor. Anterior spinal reconstruction and posterior instrumentation were performed, with abundant bone autograft and allograft used to achieve sufficient boney fusion following the removal of the tumor. RESULTS: At 2 years after surgery, the patient had made a sufficient recovery from his symptoms. The bone union was complete without tumor recurrence or implant failure. CONCLUSIONS: Total spondylectomy and spinal reconstruction with instrumentation might be useful for performing the safe and adequate excision of recurrent HPC of the spine. However, patients should be closely monitored to detect local recurrence and the malignant degeneration of the tumor after surgery.
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