Background: The spinal column is a major site of neoplastic proliferation where decisions regarding surgical or radiotherapeutic intervention are based upon spinal instability neoplastic score (SINS). A novel technique named ‘Intraoperative radiotherapy (IORT) was proposed where surgery and radiotherapy were performed in the same session. During our literature search, we found no published systematic review or meta-analysis regarding the outcomes of IORT for spinal tumors. This review aims to provide the knowledge regarding the outcomes of IORT for spinal tumors to assist surgeons and radiologists. Methods: PubMed, Google Scholar, Cochrane library for trials reporting the outcomes of IORTin spinal tumors. The search terms were “outcomes”, “Intraoperative radiotherapy”, “IORT”, “spine neoplasia” and “spine metastasis” in different combinations. Standardized mean difference (SMD) in VAS for pain relief while proportionality for neurological improvement, local progression, and toxicities were plotted on forest plots, respectively. Results: Eight studies comprising 610 patients were included with two conference proceedings. SMD for VAS was -1.715 while proportionality for neurological improvement, local progression, and toxicities were 0.9 (90%), 0.03 (3%), and 0.121 (12.1%), respectively. Conclusion: Pain relief was evident by a decrease in VAS scores in the majority of patients. The majority showed neurological improvement and regained motor and sensory functions while an overwhelming population showed local tumor control with lesser patients developing tumor progression and radiation-induced toxicities. Short follow-ups and the absence of randomized trials advocates the need for further clinical researches to confirm the outcomes of IORT in spinal tumors.

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Background: One of the methods of stabilizing the stump of the ulna following resection of the distal ulna is tenodesis of the extensor carpi ulnaris (ECU). Some studies have recommended stabilization, whereas others have not found it useful. Most of these studies have a mix of different pathologies and often do not have a control group. The aim of this study is to compare the outcomes of ECU tenodesis versus no tenodesis after resection of the distal ulna in patients with grade III giant cell tumor (GCT) of the distal ulna. Methods: The retrospective study included 10 patients with Campanacci grade III GCT of the distal ulna treated by resection of the distal ulna between 2014 and 2019. Patients were stratified into two groups based on whether they underwent ECU tenodesis (n = 5) or no tenodesis (n = 5). The patients were assessed at 6 weeks, 6 months, and 12 months for complications and outcomes using the Mayo wrist score (MWS) and the revised musculoskeletal tumor society score (MSTS). Results: The MWS and the MSTS were significantly better in the ECU tenodesis group at 6 weeks. At 6 months, MWS was similar in both groups, but MSTS continued to be significantly better in ECU tenodesis group. At 12 months, both groups reported similar MWS and MSTS. There were no recurrences in either groups. One patient in the ECU tenodesis group developed ECU tendonitis that resolved with conservative treatment. Conclusions: The outcomes of ECU tenodesis were better in the short term (6 months), although both groups reported similar outcomes at 12 months. Level of Evidence: Level III (Therapeutic)

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