Modified En Bloc Spondylectomy for Tumors of the Thoracic and Lumbar Spine

Shah, Akash; Pereira, Nuno Rui Paulino; Pedlow, Frank X.; Wain, John C.; Yoon, Sam S.; Hornicek, Francis J.; Schwab, Joseph H.

doi:10.2106/jbjs.17.00141

Cited by 56 publications

(33 citation statements)

References 37 publications

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“…In a recent well documented article by Shah et al (15) an interesting use of the threadwire saw is proposed. It is an interesting tip, whose application however is limited to some part of the thoracic and lumbar spine: it is not applicable to high thoracic spine neither to low lumbar spine.…”

mentioning

confidence: 99%

En bloc resection in the spine: a procedure of surgical oncology

Boriani¹

2018

J Spine Surg

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mentioning

confidence: 99%

En bloc resection in the spine: a procedure of surgical oncology

Boriani¹

2018

J Spine Surg

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“…Therefore, this technique likely does not increase the infection rate, especially considering the short time required for positioning the satellite rod via a connector. Compared with the procedures in previous studies [6,32,33], the procedure did not signi cantly increase the number of xed segments, operation time, volume of blood loss or complications, although 2 additional rods were implanted. From the perspective of e ciency, procedure in which satellite rods are added is relatively safe, quick and well controlled.…”

Section: Discussionmentioning

confidence: 69%

Total en bloc spondylectomy combined with the satellite rod technique for spinal tumors

Wei

Dong

et al. 2020

Preprint

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Background: Instrumentation failure (IF) is a common complication after total en bloc spondylectomy (TES) in spinal tumors. This study aims to evaluate the clinical outcomes of TES combined with the satellite rod technique for the treatment of primary and metastatic spinal tumors.Methods: The clinical data of 15 consecutively treated patients with spinal tumors who underwent TES combined with satellite rod technique by a single posterior approach from June 2015 to September 2018 were analyzed retrospectively. Radiographic parameters including the local kyphotic angle (LKA), anterior vertebral height (AVH), posterior vertebral height (PVH) and intervertebral titanium mesh cage height (ITMCH) were assessed preoperatively, postoperatively and at the final follow-up. The visual analog scale (VAS), Oswestry Disability Index (ODI) and American Spinal Injury Association (ASIA) scale were used to assess quality of life and neurological function. The operative duration, volume of blood loss, and complications were also recorded.Results: The mean operation time and volume of blood loss were 361.7 min and 2816.7 mL, respectively. During an average follow-up of 31.1 months, 2 patients died of tumor recurrence and multiple organ metastases, while recurrence was not found in any other patients. Solid fusion was achieved in all but one patient, and no implant-related complications occurred during the follow-up. The VAS, ODI and ASIA scores significantly improved from before to after surgery (P<0.05). The LKA, AVH and PVH significantly improved from before to immediately after surgery and to the final follow-up (P<0.05), and the postoperative and final follow-up values did not significantly differ (P>0.05).Conclusions: TES combined with the satellite rod technique can yield strong three-dimensional fixation and reduce the occurrence of rod breakage, thereby improving the long-term quality of life of patients with spinal tumors.

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“…4) Several case series reported favorable outcomes following total en bloc resection of these surgical resections, such as piecemeal resection. 12,13) In the current study, 17 of 33 (51.5%) patients underwent total en bloc resection (spondylectomy or sagittal resection) and a negative margin was achieved in 12 of 33 (36.4%) patients.…”

Section: Wwwkrspineorg 121mentioning

confidence: 59%

Clinical Significance of Resection Type and Margin following Surgical Treatment for Primary Sarcoma of the Spine: A Multi-Center Retrospective Study

Chang

Kim

Park

et al. 2019

J Korean Soc Spine Surg

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Study Design:A retrospective multi-center study. Objectives: To analyze oncological outcomes according to the resection type and surgical margin following surgical treatment for primary spinal sarcoma. Summary of Literature Review: Previous studies using registry databases have shown that surgery and negative margins were associated with improved survival for primary spinal sarcoma. However, few studies have comprehensively analyzed the clinical significance of the resection type and surgical margin for the oncological outcomes of this rare malignancy. Materials and Methods:We retrospectively reviewed consecutive patients who underwent surgical resection for primary spinal sarcoma between 1997 and 2016 at two tertiary medical centers. Overall survival and the occurrence of local recurrence and distant metastasis were compared between the groups using Kaplan-Meier curve analysis and the log-rank test. Results: Thirty-three patients (21 males,12 females) with a mean age of 45.1 years and a median follow-up of 36 months were included. There were 13 (39.4%) chondrosarcomas, 12 (36.4%) osteosarcomas, and eight different histological diagnoses. The cohort was categorized into four groups: 1) total en bloc resection with a negative margin (n=12; 36.4%), 2) total en bloc resection with a positive margin: (n=5; 15.2%), 3) total piecemeal resection (n=12; 36.4%), and 4) subtotal resection (n=4; 12.1%). Total en bloc resection with a negative margin was associated with improved overall survival (p=0.030) and less distant metastasis (p=0.025) and local recurrence (p=0.004). Conclusions: Achieving a negative margin through total en bloc resection, although technically demanding, improves oncological outcomes in primary spinal sarcoma. 방법(일괄 및 분할)과 수술 절제연(양성 및 음성)이 생존 기간, 국소 재발 및 원격 전이 등에 미치는 영향을 생존 분석(Kaplan-Meier curve analysis and log rank test)으 로 평가하였다. 결과: 총 33명(남자 21명, 여자 12명)의 환자가 연구에 포함되었으며, 평균 나이는 45.1세, 추시 기간의 중간값은 36개월이었다. 13(39.4%)예의 연골육 종, 12(36.4%)예의 골육종이 가장 많은 조직학적 진단을 차지하였다. 전체 환자를 절제 방법 및 절제연을 기준으로 네 그룹으로 나누었을 때, 그 분포는 다음과 같았다. 1) 완전 일괄 절제 (total en bloc resection) 및 음성 절제연: n=12(36.4%), 2) 완전 일괄 절제 및 양성 절제연: n=5(15.2%), 3) 완전 분할 절 제 (total piecemeal resection): n=12(36.4%), and 4) 불완전 절제(subtotal resection): n=4(12.1%). 생존 분석을 시행하였을 때, 완전 일괄 절제 및 음성 절 제연을 시행 받은 환자들에서 유의하게 긴 생존 기간(p=0.030), 적은 원격 전이 (p=0.025) 및 국소 재발 (p=0.004)의 발생이 관찰되었다. 결론: 원발성 악성 척추 종양에서 보다 좋은 종양학적 결과(oncological outcome)를 얻기 위해서는 완전 일괄 절제술을 통해 음성 절제연을 얻고자 하는 노력이 필요하겠다. 색인 단어: 원발성 척추 종양, 일괄절제술, 생존 분석, 국소 재발, 원격 전이 약칭 제목: 원발성 척추암의 수술적 치료

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Modified En Bloc Spondylectomy for Tumors of the Thoracic and Lumbar Spine

Abstract: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Cited by 56 publications

References 37 publications

En bloc resection in the spine: a procedure of surgical oncology

En bloc resection in the spine: a procedure of surgical oncology

Total en bloc spondylectomy combined with the satellite rod technique for spinal tumors

Clinical Significance of Resection Type and Margin following Surgical Treatment for Primary Sarcoma of the Spine: A Multi-Center Retrospective Study

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