Complications of spine surgery for metastasis

Igoumenou, Vasilios G.; Mavrogenis, Andreas F.; Angelini, Andrea; Baracco, Riccardo; Benzakour, Ahmed; Benzakour, Thami; Bork, Martin; Vazifehdan, Farzam; Nena, Ugo; Ruggieri, Pietro

doi:10.1007/s00590-019-02541-0

Cited by 43 publications

(46 citation statements)

References 119 publications

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“…The overall complication rate following surgery for spinal metastasis ranges from 10% to 66.7% in the literature [78]. Because surgery for spinal metastasis is performed to improve the quality of life of a patient, surgeons should try to minimize all possible surgical and medical complications by implementing multidisciplinary interventions.…”

Section: Postoperative Complications and Preventive Measuresmentioning

confidence: 99%

“…Among diverse complications, those that require additional attention when found in spinal metastasis patients (e.g., wound infection, instrumentation failure, and intraoperative bleeding) are briefly discussed here. The incidence of surgical site infection (SSI) is determined to be higher in spinal metastasis surgery, reaching up to 30%, as compared with during other spine surgeries [78]. SSI has also been identified as the most common cause for reoperation (in 42% of reoperations) following surgery for spinal metastasis [79].…”

Section: Postoperative Complications and Preventive Measuresmentioning

confidence: 99%

“…The incidence of surgical site infection (SSI) is determined to be higher in spinal metastasis surgery, reaching up to 30%, as compared with during other spine surgeries [ 78 ]. SSI has also been identified as the most common cause for reoperation (in 42% of reoperations) following surgery for spinal metastasis [ 79 ].…”

Section: Surgery For Metastatic Spinal Tumorsmentioning

confidence: 99%

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Treatment Strategy for Metastatic Spinal Tumors: A Narrative Review

et al. 2020

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Metastatic spinal tumors are common, and their rising incidence can be attributed to the expanding aging population and increased survival rates among cancer patients. The decision-making process in the treatment of spinal metastasis requires a multidisciplinary approach that includes medical and radiation oncology, surgery, and rehabilitation. Various decision-making systems have been proposed in the literature in order to estimate survival and suggest appropriate treatment options for patients experiencing spinal metastasis. However, recent advances in treatment modalities for spinal metastasis, such as stereotactic radiosurgery and minimally invasive surgical techniques, have reshaped clinical practices concerning patients with spinal metastasis, making a demand for further improvements on current decision-making systems. In this review, recent improvements in treatment modalities and the evolution of decision-making systems for metastatic spinal tumors are discussed.

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Section: Postoperative Complications and Preventive Measuresmentioning

confidence: 99%

Section: Postoperative Complications and Preventive Measuresmentioning

confidence: 99%

Section: Surgery For Metastatic Spinal Tumorsmentioning

confidence: 99%

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Treatment Strategy for Metastatic Spinal Tumors: A Narrative Review

et al. 2020

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“…MSTS is associated with a 29% risk of complications, 21 but the reports range from 10 to 66.7% in existing literature. 22 The utility of an invasiveness index would allow surgeons to adequately prepare for their interventions based on the patient's preoperative status. High scores can signal providers to consider appropriate resource planning for extensive surgery, optimizing general condition of the patient, and performing neoadjuvant treatments.…”

Section: Discussionmentioning

confidence: 99%

The “Spinal Metastasis Invasiveness Index”

Kumar

Ramos

Patel

et al. 2020

Spine

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Study Design. Retrospective review. Objective. The aim of this study was to develop a surgical invasiveness index for metastatic spine tumor surgery (MSTS) that can serve as a standardized tool in predicting intraoperative blood loss and surgical duration; for the purpose of ascertaining resource requirements and aiding in patient education. Summary of Background Data. Magnitude of surgery is important in the metastatic spine disease (MSD) population since these patients have a continuing postoperative oncological process; a consideration that must be taken into account to maintain or improve quality of life. Surgical invasiveness indices have been established for general spine surgery, adult deformity, and cervical deformity, but not yet for spinal metastasis. Methods. Demographic, oncological, and procedural data were collected from consecutive patients that underwent MSTS. Binary logistic regression, using median values for surgical duration and intraoperative estimated blood loss (EBL), was used to determine statistical significance of variables to be included in the “spinal metastasis invasiveness index” (SMII). The corresponding weightage of each of these variables was agreed upon by experienced spine surgeons. Multivariable regression analysis was used to predict operative time and EBL while controlling for demographical, procedural, and oncological characteristics. Results. Two hundred and sixty-one MSD patients were included with a mean age of 59.7-years and near equal sex distribution. The SMII strongly predicted extended surgical duration (R 2 = 0.28, P < 0.001) and high intraoperative blood loss (R 2 = 0.18, P < 0.001). When compared to a previously established surgical invasiveness index, the SMII accounted for more variability in the outcomes. For every unit increase in score, there was a 42-mL increase in mean blood loss (P < 0.001) and 5-minute increase in mean operative time (P < 0.001). Conclusion. Long surgical duration and high blood loss were strongly predicted by the newly developed SMII. The use of the SMII may aid in preoperative risk assessment with the goal of improving patient outcomes and quality of life. Level of Evidence: 4

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“…Cumulative endoprosthetic infection rate was 12.5% when survival at 5/10 years was 61/54% respectively. Igoumenou et al [8] proposed an extensive review of complications in spine surgery for metastasis. As the metastatic spinal disease is a part of a systemic disease, its optimal management requires a multidisciplinary therapeutic approach involving medical and radiation oncologists, diagnostic and interventional radiologists, neurologists, surgeons and palliative care pain control specialists.…”

mentioning

confidence: 99%

Orthopedic oncology: What’s new in 2019?

Simon¹

2019

Eur J Orthop Surg Traumatol

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Complications of spine surgery for metastasis

Cited by 43 publications

References 119 publications

Treatment Strategy for Metastatic Spinal Tumors: A Narrative Review

Treatment Strategy for Metastatic Spinal Tumors: A Narrative Review

The “Spinal Metastasis Invasiveness Index”

Orthopedic oncology: What’s new in 2019?

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