骨盤腫瘍に対する Cotrel Dubousset Instrumentation (CDI) による脊椎骨盤再建術の小経験

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Case 1. A fifty-four-year-old man reported a severe pair from the perineum radiating to the left leg. A hepatocellular carcinoma and a metastatic tumor of the sacrum was diagnosed by his local doctor. The patient was admitted to our hospital for treatment of the hepatocellular carcinoma. He was treated with transcatheter hepatic arterial embolization and was irradiated with 50Gy to his pelvis. Two years later, he began complaining of severe low back pain when in a sitting position. He received surgical intervention for decompression of the cauda equina, as well as stabilization of the pelvic ring with CDI. Postoperatively the severe low back pain disappeared.
Case 2. A fifty-year-old women noted severe pain radiating from the perinuem to the left leg. She had been operated on in 1977, 1981, 1984 and 1988 for pelvic chondrosarcoma. X-rays examination showed lytic destruction from the fifth lumbar vertebra, sacrum to the iliac bone. Recurrence of the pelvic chondrosacoma was diagnosed and intralesional resection of the pelvic tumor and reconstruction of the pelvic ring with CDI was performed.
Limb salvage for patients with malignant pelvic tumors remains a problem from the reconstructive standpoint. CDI consists of a rod, and hooks and screws and the transverse traction device and dominos. CDI achieve stable vertebral and pelvic osteosynthesis.