Case Report
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Solitary involvement of multiple myeloma in the upper thoracic spine, and anterior approach to thoracic region without full sternotomy: A case report

Year 2018, Volume: 2 Issue: 3, 403 - 405, 01.09.2018
https://doi.org/10.28982/josam.437453

Abstract

Multiple myeloma is cancer that starts in the plasma cells in bone marrow. Bone x- rays may show fractures or hollowed out areas of bone. The most common skeletal sites are pelvis, skull, spine, ribs and femoral and humeral shafts. The unique anatomy of thoracic spine creates challenging surgery approaches. Treatment choices of hematological malignancies of the spine are surgery, chemotherapy and radiotherapy. Unilateral L-shaped manubriotomy does not require full sternotomy for upper thoracic segment pathologies. We present a case of multiple myeloma patient in the upper thoracic area and the surgical management. We present an approach to anterior pathology of the upper thoracic spine that obviates the need for sternotomy.

References

  • 1. Sundaresan N, Shah J, Foley KM, Rosen G. An anterior surgical approach to the upper thoracic vertebrae. J Neurosurg. 1984;61(4):686-90.
  • 2. Lall RR, Smith ZA, Wong AP, Miller D, Fessler RG. Minimally invasive thoracic corpectomy: surgical strategies for malignancy, trauma, and complex spinal pathologies. Minim Invasive Surg. 2012;2012:213791.
  • 3. Gokaslan ZL, York JE, Walsh GL, McCutcheon IE, Lang FF, Putnam JB Jr, Wildrick DM, Swisher SG, Abi-Said D, Sawaya R. Transthoracic vertebrectomy for metastatic spinal tumors. J Neurosurg. 1998;89(4):599-609.
  • 4. Tamburrelli FC, Proietti L, Scaramuzzo L, De Stefano V, Logroscino CA. Bisphosphonate therapy in multiple myeloma in preventing vertebral collapses: preliminary report. Eur Spine J 21 Suppl. 2012;1:141-5.
  • 5. Flouzat-Lachaniette CH, Allain J, Roudot-Thoraval F, Poignard A. Treatment of spinal epidural compression due to hematological malignancies: a single institution's retrospective experience. Eur Spine J (E Pub). 2012;10.
  • 6. Tarantino R, Donnarumma P, Marruzzo D, Landi A, Giacomo T, Delfini R. Anterior surgical approaches to the cervicothoracic junction: when to use the manubriotomy? Spine J. 2013 Mar 30. doi:pii: S1529-9430(13)00249-0.
  • 7. Donnarumma P, Nigro L, Tarantino R, De Giacomo T, Delfini R. The Manubriotomy is a safe option for the anterior approach to the cervico-thoracic junction. Journal of Spine Surgery. 2017;3(3):426-8.
  • 8. Pointillart V, Aurouer N, Gangnet N, Vital JM. Anterior approach to the cervicothoracic junction without sternotomy: a report of 37 cases. Spine. 2007;32(25):2875-9.
  • 9. Luk KD, Cheung KM, Leong JC. Anterior approach to the cervicothoracic junction by unilateral or bilateral manubriotomy. A report of five cases. J Bone Joint Surg Am. 2002;84(6):1013-7.
  • 10. Comey CH, McLaughlin MR, Moossy J. Anterior thoracic corpectomy without sternotomy: a strategy for malignant disease of the upper thoracic spine. Acta Neurochir (Wien). 1997;139(8):712-8.
  • 11. Huang Y, Tian N, Chi Y, Wang S, Pan J, Xu H. Mini open anterior approach to the cervicothoracic junction: a cadaveric study. Eur Spinr J. 2013 doi:10.1007/s00586-2766-9.
  • 12. Darling GE, McBroom R, Perrin R. Modified anterior approach to the cervico- thoracic junction. Spine. 1995;20:1519-21.

Üst torasik omurgada multipl miyelomun soliter tutulumu ve sternotomi yapılmaksızın torasik bölgeye anterior yaklaşım: Olgu sunumu

Year 2018, Volume: 2 Issue: 3, 403 - 405, 01.09.2018
https://doi.org/10.28982/josam.437453

Abstract

Multipl miyelom kemik iliğindeki plasma hücrelerinden başlayan bir kanser türüdür. Kemik grafileri kemikteki kırıkları ve oyukları gösterebilir. En sık tutulan iskelet alanları pelvis, kafatası, kaburgalar ve femur- humerus kemikleridir. Torasik omurganin özellikli anatomisi, bu bölgenin cerrahi yaklaşımlarını oldukça zorlaştırır. Omurgadaki hematolojik hastalıkların tedavi seçenekleri arasında cerrahi, kemoterapi ve radyoterapi seçenekleri yeralmaktadır. Tek taraflı L- şekilli manubriyotomi sayesinde üst torasik bölge patolojilerine yaklaşımlarda tam sternotomi gerekmemektedir. Üst torasik omur multiple myeloma hastasının cerrahi yönetimini sunmayı amaçladık. Sunulan cerrahi yöntem üst torasik bölgeye yaklaşımda sternotomi ihtiyacını ortadan kaldırmaktadır.

References

  • 1. Sundaresan N, Shah J, Foley KM, Rosen G. An anterior surgical approach to the upper thoracic vertebrae. J Neurosurg. 1984;61(4):686-90.
  • 2. Lall RR, Smith ZA, Wong AP, Miller D, Fessler RG. Minimally invasive thoracic corpectomy: surgical strategies for malignancy, trauma, and complex spinal pathologies. Minim Invasive Surg. 2012;2012:213791.
  • 3. Gokaslan ZL, York JE, Walsh GL, McCutcheon IE, Lang FF, Putnam JB Jr, Wildrick DM, Swisher SG, Abi-Said D, Sawaya R. Transthoracic vertebrectomy for metastatic spinal tumors. J Neurosurg. 1998;89(4):599-609.
  • 4. Tamburrelli FC, Proietti L, Scaramuzzo L, De Stefano V, Logroscino CA. Bisphosphonate therapy in multiple myeloma in preventing vertebral collapses: preliminary report. Eur Spine J 21 Suppl. 2012;1:141-5.
  • 5. Flouzat-Lachaniette CH, Allain J, Roudot-Thoraval F, Poignard A. Treatment of spinal epidural compression due to hematological malignancies: a single institution's retrospective experience. Eur Spine J (E Pub). 2012;10.
  • 6. Tarantino R, Donnarumma P, Marruzzo D, Landi A, Giacomo T, Delfini R. Anterior surgical approaches to the cervicothoracic junction: when to use the manubriotomy? Spine J. 2013 Mar 30. doi:pii: S1529-9430(13)00249-0.
  • 7. Donnarumma P, Nigro L, Tarantino R, De Giacomo T, Delfini R. The Manubriotomy is a safe option for the anterior approach to the cervico-thoracic junction. Journal of Spine Surgery. 2017;3(3):426-8.
  • 8. Pointillart V, Aurouer N, Gangnet N, Vital JM. Anterior approach to the cervicothoracic junction without sternotomy: a report of 37 cases. Spine. 2007;32(25):2875-9.
  • 9. Luk KD, Cheung KM, Leong JC. Anterior approach to the cervicothoracic junction by unilateral or bilateral manubriotomy. A report of five cases. J Bone Joint Surg Am. 2002;84(6):1013-7.
  • 10. Comey CH, McLaughlin MR, Moossy J. Anterior thoracic corpectomy without sternotomy: a strategy for malignant disease of the upper thoracic spine. Acta Neurochir (Wien). 1997;139(8):712-8.
  • 11. Huang Y, Tian N, Chi Y, Wang S, Pan J, Xu H. Mini open anterior approach to the cervicothoracic junction: a cadaveric study. Eur Spinr J. 2013 doi:10.1007/s00586-2766-9.
  • 12. Darling GE, McBroom R, Perrin R. Modified anterior approach to the cervico- thoracic junction. Spine. 1995;20:1519-21.
There are 12 citations in total.

Details

Primary Language English
Subjects Surgery, Health Care Administration
Journal Section Case report
Authors

Mehmet Bülent Önal 0000-0003-0563-3221

Atilla Kırçelli This is me 0000-0003-2109-1274

Erdinç Civelek 0000-0002-3988-4064

Publication Date September 1, 2018
Published in Issue Year 2018 Volume: 2 Issue: 3

Cite

APA Önal, M. B., Kırçelli, A., & Civelek, E. (2018). Solitary involvement of multiple myeloma in the upper thoracic spine, and anterior approach to thoracic region without full sternotomy: A case report. Journal of Surgery and Medicine, 2(3), 403-405. https://doi.org/10.28982/josam.437453
AMA Önal MB, Kırçelli A, Civelek E. Solitary involvement of multiple myeloma in the upper thoracic spine, and anterior approach to thoracic region without full sternotomy: A case report. J Surg Med. September 2018;2(3):403-405. doi:10.28982/josam.437453
Chicago Önal, Mehmet Bülent, Atilla Kırçelli, and Erdinç Civelek. “Solitary Involvement of Multiple Myeloma in the Upper Thoracic Spine, and Anterior Approach to Thoracic Region Without Full Sternotomy: A Case Report”. Journal of Surgery and Medicine 2, no. 3 (September 2018): 403-5. https://doi.org/10.28982/josam.437453.
EndNote Önal MB, Kırçelli A, Civelek E (September 1, 2018) Solitary involvement of multiple myeloma in the upper thoracic spine, and anterior approach to thoracic region without full sternotomy: A case report. Journal of Surgery and Medicine 2 3 403–405.
IEEE M. B. Önal, A. Kırçelli, and E. Civelek, “Solitary involvement of multiple myeloma in the upper thoracic spine, and anterior approach to thoracic region without full sternotomy: A case report”, J Surg Med, vol. 2, no. 3, pp. 403–405, 2018, doi: 10.28982/josam.437453.
ISNAD Önal, Mehmet Bülent et al. “Solitary Involvement of Multiple Myeloma in the Upper Thoracic Spine, and Anterior Approach to Thoracic Region Without Full Sternotomy: A Case Report”. Journal of Surgery and Medicine 2/3 (September 2018), 403-405. https://doi.org/10.28982/josam.437453.
JAMA Önal MB, Kırçelli A, Civelek E. Solitary involvement of multiple myeloma in the upper thoracic spine, and anterior approach to thoracic region without full sternotomy: A case report. J Surg Med. 2018;2:403–405.
MLA Önal, Mehmet Bülent et al. “Solitary Involvement of Multiple Myeloma in the Upper Thoracic Spine, and Anterior Approach to Thoracic Region Without Full Sternotomy: A Case Report”. Journal of Surgery and Medicine, vol. 2, no. 3, 2018, pp. 403-5, doi:10.28982/josam.437453.
Vancouver Önal MB, Kırçelli A, Civelek E. Solitary involvement of multiple myeloma in the upper thoracic spine, and anterior approach to thoracic region without full sternotomy: A case report. J Surg Med. 2018;2(3):403-5.