Perioperative Complications and Prognosis of Curative Surgical Resection for Spinal Metastases in Elderly Patients

Yonezawa, Noritaka; Murakami, Hideki; Demura, Satoru; Kato, Satoshi; Yoshioka, Katsuhito; Shinmura, Kazuya; Yokogawa, Noriaki; Shimizu, Takaki; Oku, Norihiro; Kitagawa, Ryo; Handa, Makoto; Annen, Ryohei; Kurokawa, Yuki; Tsuchiya, Hiroyuki

doi:10.1016/j.wneu.2020.01.093

Cited by 9 publications

(13 citation statements)

References 28 publications

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“…2). Favorable outcomes in this regard have been reported in the literature [74][75][76]. However, some authors recently reported that curative Fig.…”

Section: Role Of Curative Surgery (En Bloc Resection)mentioning

confidence: 97%

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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“…2). Favorable outcomes in this regard have been reported in the literature [74][75][76]. However, some authors recently reported that curative Fig.…”

Section: Role Of Curative Surgery (En Bloc Resection)mentioning

confidence: 97%

Treatment Strategy for Metastatic Spinal Tumors: A Narrative Review

et al. 2020

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“…Although fair evaluation and comparison of the data were difficult because of the different definitions, a significant proportion of patients, between 13% and 67%, experienced perioperative complications. Some authors reported a significantly higher frequency of serious postoperative complications in elderly patients and patients undergoing resection of multilevel vertebrae [60, 79, 82]. In our retrospective study of 307 patients undergoing SM of spinal metastases between 1990 and 2017, we reported that 20% of the patients had intraoperative bleeding more than 2,000 mL, and four patients (1.3%) died within 2 months [60].…”

Section: Resultsmentioning

confidence: 89%

“…Contrary to the expectations of most clinicians, the development of effective and modern systemic treatment modalities has increased the number of spinal SM and the publication of related articles, especially in Asian countries [33–36, 68, 73, 77–82, 99–102]. Although the number of candidates with an indication for spinal SM is still limited among patients with spinal metastases, we expect these to increase, especially in countries where SBRT is not widely available.…”

Section: Resultsmentioning

confidence: 96%

Surgical Metastasectomy in the Spine: A Review Article

et al. 2021

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“…In individual studies, fours studies reported 0 DVT events and the highest reported was by Pennington et al [19] with an incidence of 7.9% in their series. Yonezawa et al [28] found a higher incidence of DVT in patients younger than 50 (6.5%), compared to those between 50-65 (5.9%).…”

Section: Deep Venous Thrombosis (Dvt)mentioning

confidence: 95%

Antifibrinolytics use during surgery for oncological spine diseases: A systematic review

Ávila

Orenday-Barraza

Cavagnaro

et al. 2022

Surgical Neurology International

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Background: Data exist of the benefits of antifibrinolytics such as tranexamic acid (TXA) in general spine surgery. However, there are limited data of its use in oncological spine patients. Methods: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Cochrane, OVID, and Embase databases were searched. Search terms: “tranexamic acid”, “aprotinin,” “aminocaproic acid,” “spine surgery,” “spine tumors,” and “spine oncology.” Included studies were full text publications written in English with patients treated with either agent or who had surgery for oncological spine disease (OSD). Results: Seven hundred results were reviewed form the different databases, seven were selected. A total of 408 patients underwent spine surgery for OSD and received antifibrinolytics. There was a male predominance (55.2%) and mean age ranged from 43 to 62 years. The most common tumor operated was metastatic renal cancer, followed by breast and lung. Most studies administered TXA as a bolus followed by an infusion during surgery. Median blood loss was of 667 mL (253.3–1480 mL). Patients with TXA required 1–2 units less of transfusion and had 56–63 mL less of postoperative drainage versus no TXA. The median incidence of deep venous thrombosis (DVT) was 2.95% (0–7.9%) and for pulmonary embolism (PE) was 4.25% (0–14.3%). The use of TXA reduced intraoperative blood loss, transfusions and reduced postoperative surgical drainage output compared to no TXA use in patients with OSD. Conclusion: In this review, we found that TXA may diminish intraoperative blood loss, the need for transfusion and postoperative drainage from surgical drains when used in OSD without major increase in rates of DVT or PE.

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Perioperative Complications and Prognosis of Curative Surgical Resection for Spinal Metastases in Elderly Patients

Cited by 9 publications

References 28 publications

Treatment Strategy for Metastatic Spinal Tumors: A Narrative Review

Treatment Strategy for Metastatic Spinal Tumors: A Narrative Review

Surgical Metastasectomy in the Spine: A Review Article

Antifibrinolytics use during surgery for oncological spine diseases: A systematic review

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