An Improved Hemicorporectomy Technique
M. Burhan Janjua *
Washington University School of Medicine, St. Louis, MO, USA.
David C. Crafts
Saint Louis University Medical Center, St. Louis, MO, USA and Veterans Affairs Medical Center, St. Louis, MO, USA.
Frank E. Johnson
Saint Louis University Medical Center, St. Louis, MO, USA and Veterans Affairs Medical Center, St. Louis, MO, USA.
*Author to whom correspondence should be addressed.
Abstract
Background: The first attempted hemicorporectomy, also known as translumbar amputation (TLA), was reported in 1960. The first TLA with survival was performed in 1961. It is a lifesaving procedure initially designed for carefully selected patients with otherwise terminal cancer. The most common indications now are benign conditions such as chronic osteomyelitis of the pelvis in paraplegic patients. It is also the only procedure in which the spine is electively divided. We report our experience with four patients who had this operation, all done in two stages.
Methods: We reviewed the current literature and report techniques used in our series.
Results: We found 20 references via computer search; 14 described technical features. We describe our current technique in this report.
Conclusion: TLA can be carried out with good results. Our technique minimizes blood loss, decreases operative time, and preserves one vertebral body, compared to other techniques.
Summary: Hemicorporectomy is rarely performed. We discuss the history and rationale of the operation and describe what we consider the optimal technique, based on our series of four, with a minimal complication rate and zero mortality.
Keywords: Hemicorporectomy, translumbar amputation, division of the spine.