Surgical Treatment of Tumors of the Spine

Lee, Casey K.; Rosa, Richard; Fernand, Robert

doi:10.1097/00007632-198604000-00004

Cited by 36 publications

(9 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Sacral procedures have had historically higher rates of infection than other spinal procedures [5][6][7][8][9][10]. Primary sacral tumors are rare, and experience with postoperative wound complications of these tumors is, therefore, limited to observations on less than 80 patients [2,[11][12][13][14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Experience with wound complications after surgery for sacral tumors

Guo

et al. 2013

Eur Spine J

View full text Add to dashboard Cite

Purpose The aim of this article is to summarize our experience in treating sacral wound complications after sacrectomy. We focus, in particular, on factors associated with wound complications, including surgical site infection (SSI) and wound dehiscence. Methods The definition of SSI devised by Horgan et al. was applied. Wound dehiscence was defined as a wound showing breakdown in the absence of clinical signs meeting the diagnostic standard for SSI. Between September 1997 and August 2009, 387 patients with a sacral tumor underwent sacrectomy performed by the same team of surgeons and were followed up for C12 months. Potential risk factors were evaluated for univariate associations with SSI and wound complications. Multivariable conditional logistic regression was used to identify the combined effects of several risk factors. Results Of the 387 wounds studied, 274 healed uneventfully, and 113 (29.2 %) broke down because of infection or dehiscence. Fifty-one (13.2 %) patients developed a postoperative SSI, and 62 (16.0 %) patients developed wound dehiscence. Gram-negative bacteria grew in 45 cultures (91.8 %) and included 38 cases of Escherichia coli. Previous radiation, rectum rupture, longer duration of surgery, and cerebrospinal fluid leakage were significantly associated with increased likelihood of developing an SSI. Previous radiation, rectum rupture, age \40 years, history of diabetes mellitus, maximum tumor diameter C10 cm, and instrumentation used were risk factors for wound complications. Conclusions The incidence of wound complications is not so high at a musculoskeletal tumor center with surgeons experienced in treating sacral tumors. Controlling for these risk factors when possible may improve clinical outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Experience with wound complications after surgery for sacral tumors

Guo

et al. 2013

Eur Spine J

View full text Add to dashboard Cite

show abstract

“…16,17 Other reports recommend a more aggressive approach and require only a 3-month life expectancy. [18][19][20][21] Since it is frequently impossible to determine within months a patient's life expectancy, the decision for surgery should not be based entirely on presumed survival. It is important to consider the patient's quality of life, which can be profoundly improved with timely surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Treatment and prognosis of patients with paraplegia or quadriplegia because of metastatic spinal cord compression in prostate cancer

Nagata

Ueda

Komiya

et al. 2003

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

“…Surgical treatment had been prevented by the thoracolumbar spine's close proximity to the surrounding neurovascular structures, i.e., the aorta, caval vein, myelon and nerve roots. Therefore, an intralesional corpectomy by piecemeal resection was considered as the only feasible surgery [12,22,23,26,33,54,64,68] followed by anterior-posterior stabilization of the resulting segmental spinal defect. However, the overwhelming majority of these intralesional resection patients have shown a poor oncological outcome [17,44,64].…”

Section: Introductionmentioning

confidence: 99%

En bloc spondylectomy reconstructions in a biomechanical in-vitro study

et al. 2008

View full text Add to dashboard Cite

Wide surgical margins make en bloc spondylectomy and stabilization a referred treatment for certain tumoral lesions. With a total resection of a vertebra, the removal of the segment's stabilizing structures is complete and the instrumentation guidelines derived from a thoracolumbar corpectomy may not apply. The influence of one or two adjacent segment instrumentation, adjunct anterior plate stabilization and vertebral body replacement (VBR) designs on post-implantational stability was investigated in an in-vitro en bloc spondylectomy model. Biomechanical in-vitro testing was performed in a six degrees of freedom spine simulator using six human thoracolumbar spinal specimens with an age at death of 64 (±20) years. Following en bloc spondylectomy eight stabilization techniques were performed using long and short posterior instrumentation, two VBR systems [(1) an expandable titanium cage; (2) a connected long carbon fiber reinforced composite VBR pedicle screw system)] and an adjunct anterior plate. Testsequences were loaded with pure moments (±7.5 Nm) in the three planes of motion. Intersegmental motion was measured between Th12 and L2, using an ultrasound based analysis system. In flexion/extension, long posterior fixations showed significantly less range of motion (ROM) than the short posterior fixations. In axial rotation and extension, the ROM of short posterior fixation was equivalent or higher when compared to the intact state. There were only small, nonsignificant ROM differences between the long carbon fiber VBR and the expandable system. Antero-lateral plating stabilized short posterior fixations, but did not markedly effect long construct stability. Following thoracolumbar en bloc spondylectomy, it is the posterior fixation of more than one adjacent segment that determines stability. In contrast, short posterior fixation does not sufficiently restore stability, even with an antero-lateral plate. Expandable verses nonexpandable VBR system design does not markedly affect stability.

show abstract

Surgical Treatment of Tumors of the Spine

Cited by 36 publications

References 0 publications

Experience with wound complications after surgery for sacral tumors

Experience with wound complications after surgery for sacral tumors

Treatment and prognosis of patients with paraplegia or quadriplegia because of metastatic spinal cord compression in prostate cancer

En bloc spondylectomy reconstructions in a biomechanical in-vitro study

Contact Info

Product

Resources

About