Aims

A variety of surgical methods and strategies have been demonstrated for Andersson lesion (AL) therapy. In 2011, we proposed and identified the feasibility of stabilizing the spine without curettaging the vertebral or discovertebral lesion to cure non-kyphotic AL. Additionally, due to the excellent reunion ability of ankylosing spondylitis, we further came up with minimally invasive spinal surgery (MIS) to avoid the need for both bone graft and lesion curettage in AL surgery. However, there is a paucity of research into the comparison between open spinal fusion (OSF) and early MIS in the treatment of AL. The purpose of this study was to investigate and compare the clinical outcomes and radiological evaluation of our early MIS approach and OSF for AL.

Introduction: Primary bone lymphoma is a rare neoplastic disease of bone. Treatment consists predominantly of chemotherapy and radiotherapy. Surgery can be considered for large lytic lesions with impending pathological fractures. This study was performed to find the functional and oncological outcome of patients who underwent limb salvage surgery and custom mega prosthesis for lymphoma of bone. Materials and Methods: Eight patients with lymphoma of bone underwent limb salvage surgery and reconstruction with custom made prosthesis. Males predominated in the study with the average age of 30 years. Lower limb was commonly involved: 6 patients had tumour involving the femur. Five patients had pathological fracture. Resection and reconstruction was done using custom mega prosthesis. Proximal humeral prosthesis was used for proximal humeral tumour and proximal femoral or total hip prosthesis for proximal femoral lesion. One patient each had total femoral prosthesis and total knee prosthesis. Results: With an average follow-up of 78.6 months, two patients died of disease and one patient was alive with disease. The patient with femoral shaft lesion had intra-operative vascular injury requiring vascular repair. The patient with total knee prosthesis had superficial skin necrosis which required skin cover. The functional outcome was satisfactory in 5 patients. Discussion: Primary bone lymphoma accounts for 7% of all bone tumours. There is a male predominance and femur is the most common site of involvement. Five patients in our series had pathological fractures warranting surgical stabilisation. Limb salvage surgery with custom mega prosthesis appears to be a feasible option as more than 65% of our patients had satisfactory functional outcome. They were able to mobilise early with good pain relief and a useful functional limb