Giant Cell Tumor of Upper Thoracic Spine

Lee, Chul Gab; Kim, Sung Hoon; Kim, Dong-Min; Kim, Seok Won

doi:10.3340/jkns.2014.55.3.167

Cited by 10 publications

(8 citation statements)

References 10 publications

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“…Other series have reported the efficacy of IR with adjuvant therapy for preventing local recurrence, a technique that arguably would produce lower complication rates and less morbidity. 22 , 23 , 24 Most of these studies had limited numbers of patients. Therefore, our objective was to systematically review studies comparing the efficacy of SGCT operative treatment and to increase statistical power by performing a meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review and Meta-analysis of En Bloc Vertebrectomy Compared with Intralesional Resection for Giant Cell Tumors of the Mobile Spine

Luksanapruksa

Buchowski

Singhatanadgige

et al. 2016

Global Spine Journal

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Study Design Systematic review and meta-analysis. Objective To compare the recurrence and perioperative complication rate of en bloc vertebrectomy (EV) and intralesional resection (IR) in the giant cell tumor of the mobile spine (SGCT). Methods We systematically searched publications in the PubMed and Embase databases for reports of SGCTs, excluding the sacrum. Two reviewers independently assessed all publications. A meta-analysis was performed using local recurrence and postoperative complications as the primary outcomes of interest. Results There were four articles reporting recurrence and two articles reporting postoperative complications. All included articles were case series. In all, 91 patients were included; 49 were treated with IR and 42 were treated with EV. Local recurrence rates were 36.7 and 9.5% in the IR and EV groups, respectively. Rates of postoperative complications were 36.4% with IR and 11.1% with EV. Overall, patients treated with EV not only had a lower recurrence rate (relative risk [RR] 0.22; 95% confidence interval [CI] 0.09 to 0.52) but also had a lower postoperative complication rate (RR 0.34; 95% CI 0.07 to 1.52) compared with IR. Conclusions Based on the limited data obtained from systematic review, SGCT patients treated with EV had a lower recurrence rate and fewer postoperative complications than those treated with IR.

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Section: Discussionmentioning

confidence: 99%

Systematic Review and Meta-analysis of En Bloc Vertebrectomy Compared with Intralesional Resection for Giant Cell Tumors of the Mobile Spine

Luksanapruksa

Buchowski

Singhatanadgige

et al. 2016

Global Spine Journal

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“…Bone cement is used as an adjuvant to surgical resection to improve stability and to relieve intractable pain. Some authors have suggested that bone cement injection induces cytotoxic tumor necrosis [22, 23]. Trials of monoclonal antibody therapy for GCT, including denosumab as neoadjuvant chemotherapy, have shown favorable effects in combination with surgical downstaging, even in cases with extraosseous epidural extent [24].…”

Section: Discussionmentioning

confidence: 99%

Total Spondylectomy for Upper Thoracic Spine Giant Cell Tumor: A Case Report

et al. 2019

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Introduction: Giant cell tumors (GCT) are benign lesions that are generally locally aggressive tumors with occasional malignant behavior. These tumors are most frequently encountered in long bones; however, they also occur rarely in the spine. GCT of the spine are rare pathological entities, and spinal involvement shows a sacral predilection, with only a few cases involving the supra-sacral segment (mobile spine). Only a few cases of thoracic spinal GCT are reported in the literature; these tumors are particularly uncommon in the thoracic segment. Presentation of Case: A 29-year-old man presented with a complaint of neck pain over the previous six months that radiated to his left hand. GCT of the upper thoracic spine was diagnosed, which was surgically managed using a 2-stage approach involving total resection of the tumor followed by spondylectomy and multilevel spinal fixation. Discussion: Accurate diagnosis of vertebral column lesions, and choosing an optimum management plan are crucial. In the majority of cases, En-bloc resection of GCTs is not feasible ought to the close contact of the lesion with the spinal cord. Larger studies are encouraged to ascertain the efficacy of variable management approaches, particularly compared with piecemeal resection techniques. Conclusion: Spinal GCT are a unique group of tumors with an uncommon and unexpected presentation. Although surgery is the mainstay of treatment for spinal GCT, the management of this tumor can be challenging. No clear management algorithm has been established, and the tumor displays an unpredictable course. Therefore, each case needs tailored treatment.

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“…Screw reinforcement using bone cement appeared to be a safe method to minimize pedicle screw stress through anterior support and an effective treatment to achieve pain relief to tumor-infiltrated bone. Moreover, bone cement injection into spine tumors can be used to relieve severe pain by mechanical stabilization of bone, destruction of sensitive nerves, and necrosis of tumor cells8,9).…”

Section: Discussionmentioning

confidence: 99%

Bone Cement-Augmented Percutaneous Screw Fixation for Malignant Spinal Metastases : Is It Feasible?

Kim

2017

J Korean Neurosurg Soc

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ObjectiveWe evaluated the validity of bone cement-augmented percutaneous screw fixation for treating malignant spinal metastases.MethodsBetween 2011 and 2015, 14 patients (eight men and six women) who underwent bone cement-augmented percutaneous screw fixation for malignant spinal metastases were enrolled in this study. Their life expectancy was considered to be more than one month and less than one year, based on the revised Tokuhashi scoring system. Clinical findings including the back pain scale score, functional outcome, procedure related complications, and survival were assessed preoperatively, postoperatively, and then six months after the procedure.ResultsTwelve of the patients (86%) survived up to six months after the procedure. Three required mini-open decompressive laminectomy for severe epidural compression. Bone cement-augmented percutaneous screw fixation was performed one level above, one level below, and at the pathologic level itself. The mean operation time was 60 minutes (45–180) and blood loss was less than 100 mL. Prior to surgery, the mean pain score on the visual analogue scale was 8.8, while one month after the procedure, it had reduced to 3.0; this improvement was maintained until the six-month assessment in the surviving patients. All patients were able to sit within the first two days after surgery, and no patient experienced neurological deterioration at the one-month follow up after the surgery. No patient experienced screw loosening during the six months of follow-up. Asymptomatic cement leakage into the epidural space was observed in two patients, but no major complications were observed.ConclusionFor selected patients with malignant spinal metastases, bone cement-augmented percutaneous screw fixation can provide significant pain relief and improve quality of life.

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Giant Cell Tumor of Upper Thoracic Spine

Cited by 10 publications

References 10 publications

Systematic Review and Meta-analysis of En Bloc Vertebrectomy Compared with Intralesional Resection for Giant Cell Tumors of the Mobile Spine

Systematic Review and Meta-analysis of En Bloc Vertebrectomy Compared with Intralesional Resection for Giant Cell Tumors of the Mobile Spine

Total Spondylectomy for Upper Thoracic Spine Giant Cell Tumor: A Case Report

Bone Cement-Augmented Percutaneous Screw Fixation for Malignant Spinal Metastases : Is It Feasible?

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