Hardware Failure in Spinal Tumor Surgery: A Hallmark of Longer Survival?

Abstract

Objective: Instrumentation failure in spine tumor surgery is a common reason for revision operation. Increases in patient survival demand a better understanding of the hardware longevity. The study objective was to investigate risk factors for instrumentation failure requiring revision surgery in patients with spinal tumors.Methods: A retrospective cohort from a single tertiary care specialty hospital from January 2005 to January 2021, for patients with spinal primary or metastatic tumors who underwent surgical intervention with instrumentation. Demographic and treatment data were collected and analyzed. Kaplan-Meier analysis was performed for overall survival, and separate univariate and multivariate regression analysis was performed.Results: Three hundred fifty-one patients underwent surgical intervention for spinal tumor, of which 23 experienced instrumentation failure requiring revision surgery (6.6%). Multivariate regression analysis identified pelvic fixation (odds ratio [OR], 10.9), spinal metastasis invasiveness index (OR, 1.11), and survival of greater than 5 years (OR, 3.6) as significant risk factors for hardware failure. One- and 5-year survival rates were 57% and 8%, respectively.Conclusion: Instrumentation failure after spinal tumor surgery is a common reason for revision surgery. Our study suggests that the use of pelvic fixation, invasiveness of the surgery, and survival greater than 5 years are independent risk factors for instrumentation failure.

Carbon Fiber-Reinforced Polyetheretherketone Spinal Implants for Treatment of Spinal Tumors: Perceived Advantages and Limitations

“…The follow-up time is short, and our sample size includes both primary and metastatic tumors with relatively small numbers. Future studies are warranted to expand the cohort size, evaluate the differential impact of CFRP constructs on proton and photon-based radiotherapy, increase clinical follow-up in order to facilitate the likelihood of detecting local recurrence, follow construct durability, 22 and monitor overall survival. Additionally, matched comparisons with titanium constructs are warranted.…”

An Updated Review on the Treatment Strategy for Spinal Metastasis from the Spine Surgeon’s Perspective

“…However, it is controversial if adjuvant radiotherapy should be considered to be a risk factor for instrumentation failure [100]. Prolonged survival of patients with spinal metastasis is also associated with increased instrumentation failures [101]. Currently, limited evidence is available on the role of additional fusion procedures during surgical stabilization in reducing instrumentation failure [93,102,103].…”