Perioperative Complications of Spinal Metastases Surgery

Luksanapruksa, Panya; Buchowski, Jacob M.; Zebala, Lukas P.; Kepler, Christopher K.; Singhatanadgige, Weerasak; Bumpass, David B.

doi:10.1097/bsd.0000000000000484

Cited by 69 publications

(42 citation statements)

References 37 publications

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“…Moreover, many patients have spinal instability, poor neurological status, or goals of care that obviate en bloc resection, and these procedures are accompanied by relatively high morbidity (6,21). Debulking (when the tumor is resected in portions) or palliative (when the goal is primarily to reduce spinal cord compression) approaches may be used if en bloc resection is not possible (5,19,27). Stabilization can be performed to address spinal instability with or without accompanying decompression.…”

Section: A B Cmentioning

confidence: 99%

Treatment, complications, and outcomes of metastatic disease of the spine: from Patchell to PROMIS

Yahanda¹,

Buchowski²,

Wegner³

2019

Ann. Transl. Med

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Spinal metastases are common in patients with cancer. As cancer treatments improve and these patients live longer, the number who present with metastatic spine disease will increase. Treatment strategies for these patients continues to evolve. In particular, since the prospective randomized controlled study in 2005 by Patchell et al. showed increased survival with decompressive surgical treatment of spinal metastases, there is a growing body of literature focusing on surgical management and complications of surgery for this disease. Surgery is often one component of a multimodal treatment approach with chemotherapy and radiation, which makes it difficult to parse the benefits of each individual treatment in outcome studies. Additionally, there has been more recent emphasis placed on patient-reported outcomes (PRO) after treatment for metastatic spine disease. In this review, we summarize treatments of metastatic spinal disease, possible perioperative complications, and validated tools used to assess outcomes for these patients.

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Section: A B Cmentioning

confidence: 99%

Treatment, complications, and outcomes of metastatic disease of the spine: from Patchell to PROMIS

Yahanda¹,

Buchowski²,

Wegner³

2019

Ann. Transl. Med

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“…The surgical revision rate in this study was consistent with previous reports in the literature ranging from 10.7% to 22%. 30,31 In the KþE group, only 2 patients were revised with surgical decompression and stabilization due to progressive neurologic deficits related to tumor progression. No patients in the SþE or KþE underwent repeat treatment for persistent pain alone.…”

Section: Discussionmentioning

confidence: 99%

Treatment Outcomes in Spinal Metastatic Disease With Indeterminate Stability

Dial

Catanzano

Esposito

et al. 2020

Global Spine Journal

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Study Design: Retrospective cohort study. Objective: The purpose of this study was to compare outcomes between different treatment modalities for metastatic disease with indeterminate instability (Spinal Instability Neoplastic Score [SINS] 7-12). Methods: We retrospectively reviewed neurologically intact patients treated for spinal metastatic disease with a SINS of 7 to 12. The cohort was stratified by treatment approach: external beam radiation therapy alone (EBRT), surgery + EBRT (S+E), and cement augmentation + EBRT (K+E). Kaplan-Meier analysis was used to assess differences in length of survival (LOS) and ability to ambulate at time of death. Multivariate analysis was performed to assess adjusted LOS and ability to ambulate at time of death. Results: The cohort included 211 patients, S+E (n = 57), EBRT (n = 128), and K+E (n = 27). In the S+E group, the median LOS was 430 days, which was statistically longer than the median LOS for the EBRT group (121 days) and the K+E group (169 days). In the S+E group, 52 patients (91.2%) and in the K+E group 24 patients (92.3%) retained the ability to ambulate at their time of death compared to 99 patients (77.3%) of the EBRT patients ( P = .01). The overall rate of revision treatment at the spinal level initially treated was 17.5%, S+E (15.8%), EBRT (20.3%), and K+E (7.7%). Conclusions: The length of survival, ability to maintain ambulatory ability, and revision treatment rates were all improved following surgical management and radiation therapy compared to radiation therapy alone. The authors’ conclusion from these results are that patients with indeterminate spinal instability should be discussed in a multidisciplinary setting for the need of spinal stabilization in addition to radiation therapy.

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“…В группе II осложнения наблюдались в 11,7 % случаев: 1 пациентмедиальная мальпозиция винта; 1в отдаленном периоде после операции глубокая инфекция области хирургического вмешательства с образованием абсцесса. Luksanapruksa et al [34] отметили, что частота осложнений в хирургии опухолей позвоночника увеличилась с 5,3 до 76,2 %. Частота повторных операций -10,7 %.…”

Section: Discussionunclassified

Results of Differentiated Surgical Treatment of Aggressive Vertebral Hemangiomas

Klimov¹,

Kosimshoev²,

Евсюков³

et al. 2018

Hir. pozvonoč.

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Objective. To evaluate the outcomes of the differentiated surgical treatment in patients with aggressive vertebral hemangiomas. Material and Methods. The study included 127 patients with aggressive vertebral hemangiomas operated on in 2013-2016. The tumor localization was cervical in 9.5% of cases, thoracic in 59.8 % and lumbar in 30.7 %. Patients were divided into two groups: Group I (n = 110) with type IIIA aggressive hemangiomas, and Group II (n = 17) with type IIIB aggressive hemangiomas. Preoperative assessment included clinical and neurological examination, VAS, ODI, JOA, Weinstein-Boriani-Biagini classification, and radiography; MSCT and MRI studies of the spine were performed before treatment and in 12 months after surgery. Results. Patients in Group I underwent puncture vertebroplasty. Back pain was 6 VAS, after 12 months-2 VAS. The average preoperative ODI score was 32 and decreased to 9 in 12 months after surgery. In Group II, patients underwent decompression and stabilization with intraoperative open vertebroplasty of the affected vertebra. Preoperative embolization of tumor vessels was performed in two of 17 patients to reduce intraoperative blood loss. Preoperative back pain was 6 VAS, in 12 months after surgery-2 VAS. The ODI score showed the improvement in all patients as compared to preoperative values. Conclusion. Puncture vertebroplasty ensures the achievement of good functional result in 95.4 % of cases of type IIIA aggressive hemangioma. Decompression and stabilization surgery with intraoperative open vertebroplasty provides good functional result in 93.4 % of cases of type IIIB aggressive hemangioma. The use of vertebroplasty in type IIIB aggressive hemangiomas allows for vertebral segment stabilization with a low risk of the tumor recurrence.

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Perioperative Complications of Spinal Metastases Surgery

Cited by 69 publications

References 37 publications

Treatment, complications, and outcomes of metastatic disease of the spine: from Patchell to PROMIS

Treatment, complications, and outcomes of metastatic disease of the spine: from Patchell to PROMIS

Treatment Outcomes in Spinal Metastatic Disease With Indeterminate Stability

Results of Differentiated Surgical Treatment of Aggressive Vertebral Hemangiomas

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