Total en bloc spondylectomy with resection and replacement of the aorta: A case report and review of the literature

Hu, Jiali; Song, Guohui; Wang, J

doi:10.1016/j.asjsur.2023.05.124

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…EBR in the lumbar spine is quite dangerous, and many difficulties, such as limited working spaces between the lumbar plexus and the tumor, may be encountered. Moreover, the paravertebral tumor component can become extremely large because of the large retroperitoneal space and invasion of critical organs and major vascular structures, potentially increasing operative difficulty [ 24 ]. Furthermore, EBR in the lumbar spine generally requires a combined surgical approach because of the vital and complex anatomy, which results in a longer operation time, massive blood loss, and higher complication rates (Fig.…”

Section: Discussionmentioning

confidence: 99%

Surgical outcomes and risk factors for surgical complications after en bloc resection following reconstruction with 3D-printed artificial vertebral body for thoracolumbar tumors

Hu,

Song,

Chen

et al. 2023

World J Surg Onc

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Background The outcomes of patients with tumors of the thoracolumbar spine treated with en bloc resection (EBR) using three-dimensional (3D)-printed endoprostheses are underreported. Methods We retrospectively evaluated patients with thoracolumbar tumors who underwent surgery at our institution. Logistic regression analysis was performed to identify the potential risk factors for surgical complications. Nomograms to predict complications were constructed and validated. Results A total of 53 patients with spinal tumors underwent EBR at our hospital; of these, 2 were lost to follow-up, 45 underwent total en bloc spondylectomy, and 6 were treated with sagittal en bloc spondylectomy. The anterior reconstruction materials included a customized 3D-printed artificial vertebral body (AVB) in 10 cases and an off-the-shelf 3D-printed AVB in 41 cases, and prosthesis mismatch occurred in 2 patients reconstructed with the off-the-shelf 3D-printed AVB. The median follow-up period was 21 months (range, 7–57 months). Three patients experienced local recurrence, and 5 patients died at the final follow-up. A total of 50 perioperative complications were encountered in 29 patients, including 25 major and 25 minor complications. Instrumentation failure occurred in 1 patient, and no prosthesis subsidence was observed. Using a combined surgical approach was a dependent predictor of overall complications, while Karnofsky performance status score, lumbar spine lesion, and intraoperative blood loss ≥ 2000 mL were predictors of major complications. Nomograms for the overall and major complications were constructed using these factors, with C-indices of 0.850 and 0.891, respectively. Conclusions EBR is essential for the management of thoracolumbar tumors; however, EBR has a steep learning curve and a high complication rate. A 3D-printed AVB is an effective and feasible reconstruction option for patients treated with EBR.

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Section: Discussionmentioning

confidence: 99%