The vertebral column represents the most common bony site for metastasis with an incidence ranged from 30% to 70% in patients with metastatic neoplasms. The dorsal spine carries the highest frequent site for metastasis all over the vertebral column followed by the lumber spine. These metastatic lesions are clinical entities that often necessitate a complex spinal decompression and anterior reconstruction. Posterolateral approaches alone allow for excellent decompression with transpedicular fixation and safe visualization of the neural elements for corpectomy and reconstruction so we can avoid the complications that can happen with the staged surgery. Our aim in the study is to report cases and evaluate our approach for fixation and assess the postoperative period regarding pain improvement and neurological deficit. A retrospective study included 26 patients presented to the Neurosurgery Department at Sohag University Hospital within 3 years, between August 2014 and August 2017. Evaluation was made through using the Quebec Back Pain Disability Scale and muscle power grading scale. Twenty-six patients with metastatic dorsolumbar spine lesions underwent a single-stage surgery by midline posterior approach. Posterior decompression with transpedicular fixation above and below the affected segment was done for all patients. Unilateral facetectomies and pediculectomy followed by corpectomy were done. Insertion of pyramesh titanium cage filled with iliac bone graft with tightness of the screws bilateral. Follow-up period was 6–12 months postoperatively. The average age was 58.36 ± 5.96 (range 33–67) years. More than two-thirds of them were males (69.2%). Majority of the lesions were dorsal (77%). Postoperative infection was observed in four patients (15.4%) who improved by IV antibiotics and frequent dressing while CSF (cerebrospinal fluid) leak occurred in three patients (11.5%) who stopped after daily dressing, and we made CSF lumbar tap in one patient. Twenty-two patients showed neurological improvement postoperatively (84.6%). The remaining four were paraplegic with no improvement. Back pain improved for all cases. Posterolateral approach alone is efficient and safe for dorsolumbar decompression and reconstruction in the metastatic spine. IRB#3747 registered on August 27, 2017

中文翻译：

---

后侧椎体切除术结合金字塔形钛笼重建背阴节转移性病变

脊柱代表最常见的骨转移部位，转移性肿瘤患者的发生率在30％至70％之间。在整个脊柱中，背侧脊柱的转移频率最高，其次是腰椎。这些转移性病变是临床实体，通常需要复杂的脊柱减压和前路重建。仅通过后外侧入路，就可以通过椎弓根固定实现出色的减压效果，并可以安全地可视化用于切除和重建的神经元，因此我们可以避免分期手术可能发生的并发症。我们在研究中的目的是报告病例并评估我们的固定方法，并评估有关疼痛改善和神经功能缺损的术后时间。一项回顾性研究包括2014年8月至2017年8月在3年内向Sohag大学医院神经外科提出的26例患者。使用魁北克背痛残疾量表和肌肉力量分级量表进行评估。26例转移性背脊骨脊柱病变患者接受中线后入路单阶段手术。对所有患者均在患部上方和下方进行经椎弓根固定的后路减压。进行单侧面部切除术和根蒂切除术，然后进行大体切除术。插入装有am骨移植物的金字塔形钛质笼，双侧螺钉紧固。随访时间为术后6-12个月。平均年龄为58.36±5.96岁（33-67岁）。其中三分之二以上是男性（69.2％）。病变多数为背侧（77％）。观察到四名患者（15.4％）的术后感染，这些患者通过静脉使用抗生素和频繁的换药得到了改善，而三名（11.5％）的患者在每天换药后停药后发生了CSF（脑脊液）渗漏，我们对一名患者进行了CSF腰椎拍打。二十二例患者术后神经功能得到改善（84.6％）。其余四人截瘫，无改善。所有情况下背部疼痛均得到改善。单独的后外侧入路对于转移性脊柱背sol减压和重建是有效且安全的。IRB＃3747于2017年8月27日注册 5％）每天换药后停药的患者，我们对一名患者进行了CSF腰椎拍打。二十二例患者术后神经功能得到改善（84.6％）。其余四人截瘫，无改善。所有情况下背部疼痛均得到改善。单独的后外侧入路对于转移性脊柱背sol减压和重建是有效且安全的。IRB＃3747于2017年8月27日注册 5％）每天换药后停药的患者，我们对一名患者进行了CSF腰椎拍打。二十二例患者术后神经功能得到改善（84.6％）。其余四人截瘫，无改善。所有情况下背部疼痛均得到改善。仅后外侧入路对于转移性脊柱背减压和重建是有效且安全的。IRB＃3747于2017年8月27日注册