Id |
Subject |
Object |
Predicate |
Lexical cue |
TextSentencer_T1 |
0-34 |
Sentence |
denotes |
Total En Bloc Spondylectomy of C3: |
TextSentencer_T2 |
35-82 |
Sentence |
denotes |
A New Surgical Technique and Literature Review. |
TextSentencer_T3 |
83-167 |
Sentence |
denotes |
Totální "en bloc" spondylektomie C3: nová chirurgická technika a přehled literatury. |
TextSentencer_T4 |
168-332 |
Sentence |
denotes |
PURPOSE OF THE STUDY Radical resection of a vertebra is reserved only for specific tumors that invade the surrounding tissues and recur when not removed completely. |
TextSentencer_T5 |
333-481 |
Sentence |
denotes |
The vertebra may be removed using a piecemeal technique or en bloc, using only two (in thoracolumbar spine) or more osteotomies (in cervical spine). |
TextSentencer_T6 |
482-650 |
Sentence |
denotes |
We present our technique of en bloc resection of subaxial cervical vertebra for Ewing's sarcoma of C3, with preservation of all nerve roots and both vertebral arteries. |
TextSentencer_T7 |
651-741 |
Sentence |
denotes |
To our knowledge, this surgical technique has not been reported in the English literature. |
TextSentencer_T8 |
742-848 |
Sentence |
denotes |
The aim of this study is to describe the new technique of radical resection of subaxial cervical vertebra. |
TextSentencer_T9 |
849-997 |
Sentence |
denotes |
MATERIAL AND METHODS A transoral biopsy of tumor tissue anterior to C2-C3 was performed in 8-year old boy, revealing a diagnosis of Ewing's sarcoma. |
TextSentencer_T10 |
998-1050 |
Sentence |
denotes |
The patient was started on neoadjuvant chemotherapy. |
TextSentencer_T11 |
1051-1204 |
Sentence |
denotes |
After 6 chemotherapy cycles with the VIDE regimen, the soft-tissue component completely regressed, with the only a residual deposit in C3 vertebral body. |
TextSentencer_T12 |
1205-1364 |
Sentence |
denotes |
Based on further multidisciplinary meeting, an en bloc spondylectomy of C3 was recommended, preferably with preservation of nerve roots and vertebral arteries. |
TextSentencer_T13 |
1365-1498 |
Sentence |
denotes |
In August 2014, prior to the planned surgery, we performed another thorough examination of the patient using plain films, CT and MRI. |
TextSentencer_T14 |
1499-1550 |
Sentence |
denotes |
Neither angiography nor embolization was performed. |
TextSentencer_T15 |
1551-1669 |
Sentence |
denotes |
DESCRIPTION OF SURGICAL TECHNIQUE The first stage of the operation consisted of resection of the posterior structures. |
TextSentencer_T16 |
1670-1741 |
Sentence |
denotes |
We exposed the posterior elements of C2 to C4 by the mid-line incision. |
TextSentencer_T17 |
1742-1787 |
Sentence |
denotes |
The C3 arch was without pathological changes. |
TextSentencer_T18 |
1788-2011 |
Sentence |
denotes |
After partial resection of the C2 inferior and C4 superior articular processes we performed bilateral osteotomy in the region of the pedicle adjacent to the arch with a chisel and removed the whole of the C3 posterior arch. |
TextSentencer_T19 |
2012-2114 |
Sentence |
denotes |
Subsequently we perforated the transverse foramina close to the pedicle, using fine Kerrison rongeurs. |
TextSentencer_T20 |
2115-2177 |
Sentence |
denotes |
The lateral parts around vertebral arteries were left in situ. |
TextSentencer_T21 |
2178-2272 |
Sentence |
denotes |
In the next step we used instrumentation with polyaxial screws to stabilize the C2-C4 section. |
TextSentencer_T22 |
2273-2418 |
Sentence |
denotes |
After 19 days we performed the second stage surgery from an anterior approach with the removal of the anterior and lateral parts of the vertebra. |
TextSentencer_T23 |
2419-2594 |
Sentence |
denotes |
We made a transverse incision anterior to the sternocleidomastoid between the internal carotid artery and the trachea on the right side at the level of C3 to expose the spine. |
TextSentencer_T24 |
2595-2751 |
Sentence |
denotes |
We resected C2-C3 and C3-C4 intervertebral discs and then performed osteotomy with fine Kerrison rongeurs on both sides, again, close to the vertebral body. |
TextSentencer_T25 |
2752-2820 |
Sentence |
denotes |
Subsequently, the vertebral body was released and extracted en bloc. |
TextSentencer_T26 |
2821-2986 |
Sentence |
denotes |
In the next step, both vertebral arteries were mobilized and shifted medially and the lateral portions of the transverse processes were released and removed en bloc. |
TextSentencer_T27 |
2987-3114 |
Sentence |
denotes |
The empty space was filled with solid allograft and the C2-C4 levels were bridged by the cervical plate in 2+1+2 configuration. |
TextSentencer_T28 |
3115-3173 |
Sentence |
denotes |
RESULTS There were no complications during both surgeries. |
TextSentencer_T29 |
3174-3347 |
Sentence |
denotes |
The follow-up CT examination 4 months after the operation revealed a clear bone fusion of C2-C4, both anteriorly between vertebral bodies and posteriorly between the arches. |
TextSentencer_T30 |
3348-3463 |
Sentence |
denotes |
Clinically the patient has reached 8 month follow up and had no complaints, both he and his parents were satisfied. |
TextSentencer_T31 |
3464-3510 |
Sentence |
denotes |
Physiotherapy is proceeding according to plan. |
TextSentencer_T32 |
3511-3563 |
Sentence |
denotes |
The patient remains under supervision at our centre. |
TextSentencer_T33 |
3564-3738 |
Sentence |
denotes |
DISCUSSION Total en bloc resection of a subaxial cervical vertebra with preservation of neural and vascular structures has been described in the English literature only once. |
TextSentencer_T34 |
3739-3849 |
Sentence |
denotes |
In 2007 was published a total en bloc resection of C5 for chordoma, preserving the above mentioned structures. |
TextSentencer_T35 |
3850-3911 |
Sentence |
denotes |
Authors removed the lamina en bloc after bilateral osteotomy. |
TextSentencer_T36 |
3912-4032 |
Sentence |
denotes |
Transverse foramina were perforated by the Gigli saw and removed in piecemeal fashion, including the posterior tubercle. |
TextSentencer_T37 |
4033-4136 |
Sentence |
denotes |
In the next step, they removed the vertebral body and the anterior tubercle from the anterior approach. |
TextSentencer_T38 |
4137-4272 |
Sentence |
denotes |
However, their treatment differs from the technique described here and does not correspond fully to the principle of en bloc resection. |
TextSentencer_T39 |
4273-4450 |
Sentence |
denotes |
Our surgical technique is based on a similar principle of performing several osteotomies without the use of high speed burr, while preserving all neural and vascular structures. |
TextSentencer_T40 |
4451-4603 |
Sentence |
denotes |
The difference can be particularly seen in the approach to remove lateral parts of the transverse foramen, which are surrounding the vertebral arteries. |
TextSentencer_T41 |
4604-4714 |
Sentence |
denotes |
We consider it as ideal to split the cervical vertebra by smooth cuts into four parts and remove them en bloc. |
TextSentencer_T42 |
4715-4925 |
Sentence |
denotes |
CONCLUSION Total en bloc spondylectomy of a subaxial cervical vertebra with preservation of vertebral arteries and nerve roots is a radical surgery that should be used to treat only the most serious conditions. |
TextSentencer_T43 |
4926-5015 |
Sentence |
denotes |
The risk of neurological deficit is outweighed by the benefits of oncological radicality. |
TextSentencer_T44 |
5016-5235 |
Sentence |
denotes |
This new surgical technique has not yet been described and it is clear, that a larger cohort of patients is necessary to assess and potentially modify this technique so that it can be used more frequently in the future. |
TextSentencer_T45 |
5236-5321 |
Sentence |
denotes |
Key words: en bloc spondylectomy, total spondylectomy, cervical spine, vertebrectomy. |
T1 |
0-34 |
Sentence |
denotes |
Total En Bloc Spondylectomy of C3: |
T2 |
35-82 |
Sentence |
denotes |
A New Surgical Technique and Literature Review. |
T3 |
83-167 |
Sentence |
denotes |
Totální "en bloc" spondylektomie C3: nová chirurgická technika a přehled literatury. |
T4 |
168-332 |
Sentence |
denotes |
PURPOSE OF THE STUDY Radical resection of a vertebra is reserved only for specific tumors that invade the surrounding tissues and recur when not removed completely. |
T5 |
333-481 |
Sentence |
denotes |
The vertebra may be removed using a piecemeal technique or en bloc, using only two (in thoracolumbar spine) or more osteotomies (in cervical spine). |
T6 |
482-650 |
Sentence |
denotes |
We present our technique of en bloc resection of subaxial cervical vertebra for Ewing's sarcoma of C3, with preservation of all nerve roots and both vertebral arteries. |
T7 |
651-741 |
Sentence |
denotes |
To our knowledge, this surgical technique has not been reported in the English literature. |
T8 |
742-848 |
Sentence |
denotes |
The aim of this study is to describe the new technique of radical resection of subaxial cervical vertebra. |
T9 |
849-997 |
Sentence |
denotes |
MATERIAL AND METHODS A transoral biopsy of tumor tissue anterior to C2-C3 was performed in 8-year old boy, revealing a diagnosis of Ewing's sarcoma. |
T10 |
998-1050 |
Sentence |
denotes |
The patient was started on neoadjuvant chemotherapy. |
T11 |
1051-1204 |
Sentence |
denotes |
After 6 chemotherapy cycles with the VIDE regimen, the soft-tissue component completely regressed, with the only a residual deposit in C3 vertebral body. |
T12 |
1205-1364 |
Sentence |
denotes |
Based on further multidisciplinary meeting, an en bloc spondylectomy of C3 was recommended, preferably with preservation of nerve roots and vertebral arteries. |
T13 |
1365-1498 |
Sentence |
denotes |
In August 2014, prior to the planned surgery, we performed another thorough examination of the patient using plain films, CT and MRI. |
T14 |
1499-1550 |
Sentence |
denotes |
Neither angiography nor embolization was performed. |
T15 |
1551-1669 |
Sentence |
denotes |
DESCRIPTION OF SURGICAL TECHNIQUE The first stage of the operation consisted of resection of the posterior structures. |
T16 |
1670-1741 |
Sentence |
denotes |
We exposed the posterior elements of C2 to C4 by the mid-line incision. |
T17 |
1742-1787 |
Sentence |
denotes |
The C3 arch was without pathological changes. |
T18 |
1788-2011 |
Sentence |
denotes |
After partial resection of the C2 inferior and C4 superior articular processes we performed bilateral osteotomy in the region of the pedicle adjacent to the arch with a chisel and removed the whole of the C3 posterior arch. |
T19 |
2012-2114 |
Sentence |
denotes |
Subsequently we perforated the transverse foramina close to the pedicle, using fine Kerrison rongeurs. |
T20 |
2115-2177 |
Sentence |
denotes |
The lateral parts around vertebral arteries were left in situ. |
T21 |
2178-2272 |
Sentence |
denotes |
In the next step we used instrumentation with polyaxial screws to stabilize the C2-C4 section. |
T22 |
2273-2418 |
Sentence |
denotes |
After 19 days we performed the second stage surgery from an anterior approach with the removal of the anterior and lateral parts of the vertebra. |
T23 |
2419-2594 |
Sentence |
denotes |
We made a transverse incision anterior to the sternocleidomastoid between the internal carotid artery and the trachea on the right side at the level of C3 to expose the spine. |
T24 |
2595-2751 |
Sentence |
denotes |
We resected C2-C3 and C3-C4 intervertebral discs and then performed osteotomy with fine Kerrison rongeurs on both sides, again, close to the vertebral body. |
T25 |
2752-2820 |
Sentence |
denotes |
Subsequently, the vertebral body was released and extracted en bloc. |
T26 |
2821-2986 |
Sentence |
denotes |
In the next step, both vertebral arteries were mobilized and shifted medially and the lateral portions of the transverse processes were released and removed en bloc. |
T27 |
2987-3114 |
Sentence |
denotes |
The empty space was filled with solid allograft and the C2-C4 levels were bridged by the cervical plate in 2+1+2 configuration. |
T28 |
3115-3173 |
Sentence |
denotes |
RESULTS There were no complications during both surgeries. |
T29 |
3174-3347 |
Sentence |
denotes |
The follow-up CT examination 4 months after the operation revealed a clear bone fusion of C2-C4, both anteriorly between vertebral bodies and posteriorly between the arches. |
T30 |
3348-3463 |
Sentence |
denotes |
Clinically the patient has reached 8 month follow up and had no complaints, both he and his parents were satisfied. |
T31 |
3464-3510 |
Sentence |
denotes |
Physiotherapy is proceeding according to plan. |
T32 |
3511-3563 |
Sentence |
denotes |
The patient remains under supervision at our centre. |
T33 |
3564-3738 |
Sentence |
denotes |
DISCUSSION Total en bloc resection of a subaxial cervical vertebra with preservation of neural and vascular structures has been described in the English literature only once. |
T34 |
3739-3849 |
Sentence |
denotes |
In 2007 was published a total en bloc resection of C5 for chordoma, preserving the above mentioned structures. |
T35 |
3850-3911 |
Sentence |
denotes |
Authors removed the lamina en bloc after bilateral osteotomy. |
T36 |
3912-4032 |
Sentence |
denotes |
Transverse foramina were perforated by the Gigli saw and removed in piecemeal fashion, including the posterior tubercle. |
T37 |
4033-4136 |
Sentence |
denotes |
In the next step, they removed the vertebral body and the anterior tubercle from the anterior approach. |
T38 |
4137-4272 |
Sentence |
denotes |
However, their treatment differs from the technique described here and does not correspond fully to the principle of en bloc resection. |
T39 |
4273-4450 |
Sentence |
denotes |
Our surgical technique is based on a similar principle of performing several osteotomies without the use of high speed burr, while preserving all neural and vascular structures. |
T40 |
4451-4603 |
Sentence |
denotes |
The difference can be particularly seen in the approach to remove lateral parts of the transverse foramen, which are surrounding the vertebral arteries. |
T41 |
4604-4714 |
Sentence |
denotes |
We consider it as ideal to split the cervical vertebra by smooth cuts into four parts and remove them en bloc. |
T42 |
4715-4925 |
Sentence |
denotes |
CONCLUSION Total en bloc spondylectomy of a subaxial cervical vertebra with preservation of vertebral arteries and nerve roots is a radical surgery that should be used to treat only the most serious conditions. |
T43 |
4926-5015 |
Sentence |
denotes |
The risk of neurological deficit is outweighed by the benefits of oncological radicality. |
T44 |
5016-5235 |
Sentence |
denotes |
This new surgical technique has not yet been described and it is clear, that a larger cohort of patients is necessary to assess and potentially modify this technique so that it can be used more frequently in the future. |
T45 |
5236-5321 |
Sentence |
denotes |
Key words: en bloc spondylectomy, total spondylectomy, cervical spine, vertebrectomy. |