The entire second lumbar vertebra was replaced with a carbon expandable implant for the first time in the Czech Republic in a 13-year-old patient with Ewing's sarcoma. Due to the diagnosis and the young age of the patient, a carbon expandable cage was used for the first time together with carbon screws located at the site of the injury. The whole operation lasted five and a half hours, the implant was delivered on special request from Switzerland, and the spondylosurgeons operated on the boy both from the front and from behind.
Unfortunately, Ewing's sarcoma (a malignant bone tumor that typically occurs in children, adolescents, and young adults) affected the patient's entire lumbar vertebra, and therefore required complete removal. "First we had to completely loosen the vertebra and perform an osteotomy in its narrowest part (cut it out) so that we could first remove the posterior and then the anterior part of the vertebra in only two pieces," describes prof. MUDr. Jan Štulík, CSc., Head of the Department of Spondylosurgery, First Faculty of Medicine, Charles University and University Hospital Motol, who led the operation. After removal from the patient's body, the two parts of the vertebrae were placed back together in the hall to verify that everything was done well. Then it was possible to proceed with the replacement so that the patient was as mobile as possible, including walking, and ready for further growth.
Surgeons commonly use titanium implants in this type of operation, which, however, has one major disadvantage compared to carbon. The fact is that the so-called shadows on X-rays. "On X-ray imaging methods, carbon is fully transparent, it does not create shadow. The source of the disease can thus be very precisely targeted during subsequent irradiation, " states prof. Štulík. Carbon also has excellent both biomechanical and mechanical properties, and has undeniable advantages in terms of surgery and diagnostics.
Carbon screws have been used in FN Motol for about 2 years, but a carbon expandable cage for the first time this time. According to prof. The stalk is only suitable for exceptional operations on the thoracic and lumbar spine.
The patient was hospitalized at the Motol University Hospital for approximately three weeks. The convalescence went very well and so the boy could start walking after about a week, even if initially only with the help of crutches. She is now fully in home care.
Press Release:
TZ - Unique operations - spondylosurgery (212,38 KB)