Total En Bloc Spondylectomy for Spinal Tumors: Surgical Techniques and Related Basic Background

Kawahara, Norio; Tomita, Katsuro; Murakami, Hideki; Demura, Satoru

doi:10.1016/j.ocl.2008.09.004

Cited by 135 publications

(113 citation statements)

References 30 publications

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“…The diagnosis of spinal tumors was based on the observation of typical findings in diagnostic imaging studies. The Tokuhashi scoring system [11] was employed in preoperative assessment for prognosis of metastatic spinal tumor and Tomita's scoring system [3] was used to determine the best therapeutic option for the patient prior to surgery.…”

Section: Patients' Backgrounds and Tumor Characteristicsmentioning

confidence: 99%

“…Before en bloc corpectomy was performed, unilateral posterior instrumentation was installed to stabilize the spine. After gentle dissections of the spinal cord from the surrounding epidural venous plexus and/or the extended tumor margin in the spinal canal with a thin nerve dissector was completed, the original en bloc corpectomy characterized with ''one-step dissection'' from anterior to posterior [3] was modified by us to ''two-step dissection'' ( Fig. 1): after the disk was cut by T-saw to the level about one-third middle-posterior, L-shape chisel was inserted into the dissected space and beat away posterior-anteriorly to join forces with the T-saw.…”

Section: Surgical Procedures and Modified Techniquesmentioning

confidence: 99%

“…Total en bloc spondylectomy (TES) is a relatively new surgical technique that uses a T-saw for spinal tumors [1][2][3]. The TES technique is different from traditional intralesional resection with the characteristic of removing the whole vertebra, body and lamina as one compartment to achieve wide tumor excision.…”

Section: Introductionmentioning

confidence: 99%

“…The posterior-only approach proffers the merit of achieving complete tumor excision and circumferential spinal reconstruction in a single setting. Some studies have demonstrated TES's clinical utility and safety [3][4][5][6][7][8]. Briefly, The posterior-only approach in TES is composed of two steps: en bloc resection of the posterior element (en bloc laminectomy) and en bloc resection of the anterior part (en bloc corpectomy) [3].…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have demonstrated TES's clinical utility and safety [3][4][5][6][7][8]. Briefly, The posterior-only approach in TES is composed of two steps: en bloc resection of the posterior element (en bloc laminectomy) and en bloc resection of the anterior part (en bloc corpectomy) [3]. Theoretically, however, the procedure of TES for thoracic spinal tumors may result in severe complications such as mechanical damages to the spinal cord or major vessels, which make it technically challenging, as such its application is restricted.…”

Section: Introductionmentioning

confidence: 99%

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

Huang

Chen

et al. 2012

Eur Spine J

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Purpose The objectives of this study were to describe our surgical management with a modified total en bloc spondylectomy (TES) and to evaluate the clinical effects in patients with thoracolumbar tumors. Methods Sixteen consecutive patients with thoracolumbar neoplasms underwent a modified TES via single posterior approach followed by dorsoventral reconstruction from December 2008 to July 2011. Details of the modified technique were described and the patients' clinical information was retrospectively reviewed and analyzed. Results Significant improvements in neurological function were achieved in most of the patients. Local pain or radicular leg pain was relieved postoperatively. The mean operation time was 7.2 h, with an average blood loss of 2,300 ml. No major complications, instrumentation failure or local recurrence was found at the final follow-up. Five patients died of the disease during mean 14-month (3.0-23) follow-up. Conclusions The modified TES with a single posterior approach is feasible, safe and effective for thoracolumbar spine tumors.

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Section: Patients' Backgrounds and Tumor Characteristicsmentioning

confidence: 99%

Section: Surgical Procedures and Modified Techniquesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

Huang

Chen

et al. 2012

Eur Spine J

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Nervous System

Packer¹

2022

Veterinary Surgical Oncology

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The impact of complete surgical resection of spinal metastases on the survival of patients with thyroid cancer

et al. 2016

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Spinal metastases (SMs) from thyroid cancers significantly reduce the quality of life by causing pain and neurological deficits and increase mortality. Complete surgical resection of isolated thyroid SMs is a promising treatment option; however, the postoperative outcome is unknown. This study aimed to compare the postoperative courses of patients undergoing complete resection of thyroid SMs with those of patients undergoing incomplete resection, with a minimum 4‐year follow‐up. We performed a retrospective analysis of 32 patients who underwent tumor excision surgery for thyroid SMs at our medical center during a 28‐year period. Twenty patients underwent complete excision, and 12 underwent incomplete excision. Survival was defined as the time from the first spinal surgery to death or last follow‐up. Kaplan–Meier analysis with the long‐rank test was used to compare the overall survival rates between the groups. For all patients, the overall 5‐ and 10‐year survival rates were 71% and 31%, respectively. The median overall survival time was 6.4 years. The patients undergoing complete excision survived longer than those undergoing incomplete excision (5‐year survival: 84% vs. 50%; 10‐year survival: 52% vs. 8%; P < 0.01). Only one patient undergoing complete excision experienced local tumor recurrence in the operated spine, whereas all long‐term survivors (>18 months after surgery) in the incomplete excision group experienced local tumor recurrence and a consequent deterioration in performance status. Complete surgical resection of thyroid SMs, if achievable, has the potential not only to maintain performance status, but also to prolong survival.

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Total En Bloc Spondylectomy for Spinal Tumors: Surgical Techniques and Related Basic Background

Cited by 135 publications

References 30 publications

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

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

Nervous System

The impact of complete surgical resection of spinal metastases on the survival of patients with thyroid cancer

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