Diagnosis, surgery treatment and post-surgery process at vertebrectomy (spinal disease)

Abstract

There are several reasons how to damage spine and how to come to serious spinal disease. One of them is spinal column tumor, others are caused by local weakness, column ruptures from car accident, sport injures, long term human overloading, inflammations, etc. The first reason, spinal tumor, is probably the most serious and the correct treatment depends on factors unique to the individual patient and their individual tumor. There are a lot of therapies available to treat spinal tumors, ranging from observation to total vertebrectomy. Both, undertreatment and overtreatment as well, can lead to difficulties. A successful surgical plan is consisted of step-wise investigational algorithm. When conservative therapy failed to control metastatic disease, medicine doctors must determine whether surgery is likely to improve the body functions of patient, his quality of life, or longevity. Vertebrectomy of damaged spinal column is a very rare but serious and very complicated solution of health problem. Because of wide range of the body parts like skin, muscles (especially latissimus dorsi), heart, aorta, lungs, nerves, spinal columns, spinal cord, arm joint, rib and removement of the fifth rib and due to possible postoperative infection and pains requires surgical treatment with antibiotics and narcotics. Therefore, there is a difficult position and access in thoracic space next to vital organs, then a very high risk of massive bleeding from different ruptures and resections/cuttings can appeared. During post-surgery time the first period is in Intensive care department. All vital functions were continuously checked and treatment together with the pain were positively influenced by the correct use of drugs. On the day 3, there was the first trial to walk a few meters with the support equipment. On the day 7, the transport to the normal bed in orthopaedic clinic was realised. Starting on the day 10, normal walking began, hand in hand with improving of body posture and reactivate the rest of the body. On the day 15 after surgery, the patient was released from the hospital and went to the home health care, where treatment with the help of drugs and specific exercises continued. The pain lost approximately three months after the surgery and walking and breathing improvements progress from day to day. Forty days after vertebrectomy the treatment started to be supported by chemotherapy. Also biological treatment by using of new drug product - Tivozanib was added. Specific strengthening with the own body, breathing exercises, stretching, walking and swimming after post-surgery day 90 were applied. Progress was significant, body was more powerful, weight went up in 6 kilograms, tumor inactivity was confirmed by CT scans, range of tumor is smaller, back pain is very light or light (depends on the daily loading and rest in lying position) and health status is stabilised. Walking quality after six month is very close to the pre-surgery level and we report here the successful result of this case.