Modified total en bloc spondylectomy for thoracolumbar spinal tumors via a single posterior approach

Huang, Lin; Chen, Keng; Ye, Ji-chao; Tang, Yong; Yang, Rui; Wang, Peng; Shen, Huiyong

doi:10.1007/s00586-012-2460-3

Cited by 29 publications

(26 citation statements)

References 28 publications

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“…However, the median total operative time in our study was approximately 11 hours, shorter than that of previous reports, but we did not observe a corresponding reduction in infection rate. Although some have suggested a posterior-only approach as a means to reduce operative time, [ 20 , 21 ] a combined approach is often necessary, especially at L2 or below, to ensure surgical safety. Although no major vessel, nerve root, or bowel injuries occurred in our series, there have been reports of major vessel injury during lumbar spine TES.…”

Section: Discussionmentioning

confidence: 99%

Total en bloc spondylectomy for primary tumors of the lumbar spine

Shimizu

Murakami²,

Demura³

et al. 2018

Medicine

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This was a retrospective clinical study.This study aimed to evaluate our institution's experience with total en bloc spondylectomy (TES) in patients treated for primary lumbar spine tumors and investigate postoperative clinical outcomes.TES is a widely accepted by spinal and musculoskeletal surgical oncologists and results in favorable health-related quality of life outcomes. However, this procedure still imposes major risks and complications.The cases of TES performed for primary lumbar spine tumors between 1993 and 2015 were retrospectively analyzed. Primary outcome measures were the rates of perioperative complications and reoperation for instrumentation failure.We enrolled 30 patients (13 men and 17 women; median age and follow-up, 38 years and 87 months, respectively). Three, 7, and 5 cases involved previous radiotherapy, intralesional resection, and chemotherapy, respectively. The most common tumor was giant cell tumor (14 cases) followed by osteosarcoma (4 cases) and plasmacytoma (3 cases). The median estimated blood loss was 1450 mL, and the median operative time was 11 hours. At least 1 perioperative complication occurred in 26 patients (86.7%), with the most common being postoperative muscle weakness (24 patients, 80.0%) followed by surgical site infection and postoperative cerebrospinal fluid leakage (7 patients, respectively; 23.3% each). Revision surgery for instrumentation failure was required in 6 patients (20.0%) at a median of 33 months after the index TES. Four patients experienced local tumor recurrence (13.3%), and their 10-year disease-free rate was 75.0%.TES is a feasible and effective procedure for primary lumbar spine tumors, but the risks of perioperative complications and late instrumentation failure should be acknowledged. Surgical oncologic outcomes were good, especially in patients who underwent TES as their first surgical treatment. Therefore, being familiar with the indications for TES and the surgical technique is important.

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Section: Discussionmentioning

confidence: 99%

Total en bloc spondylectomy for primary tumors of the lumbar spine

Shimizu

Murakami²,

Demura³

et al. 2018

Medicine

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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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“…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 [6,28,29], the procedure did not signi cantly increase the number of xed segments, operation time, volume of blood loss or complications, although 1 ~ 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: 72%

Total En Bloc Spondylectomy Combined with the Satellite Rod Technique for Spinal Tumors

Wei

Dong

et al. 2020

Preprint

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Background: To evaluate the clinical outcomes of total en bloc spondylectomy (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 2018were 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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Modified total en bloc spondylectomy for thoracolumbar spinal tumors via a single posterior approach

Cited by 29 publications

References 28 publications

Total en bloc spondylectomy for primary tumors of the lumbar spine

Total en bloc spondylectomy for primary tumors of the lumbar spine

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

Total En Bloc Spondylectomy Combined with the Satellite Rod Technique for Spinal Tumors

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