Operative treatment of thoraco-lumbar metastases, using methylmetacrylate and Kempf's rods for vertebral replacement and stabilization

Lozes, G; Fawaz, A; Devos, Patrick; Wyremblewski, P; Kassiotis, P; Perper, Harry; Gozet, G; Pruvo, J. P.; Jomin, M

doi:10.1007/bf01418836

Cited by 9 publications

(6 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…23,28,31,51,53,60,63,[66][67][68] Many authors have described techniques for resection of spinal metastasis that do not require a transcavitary approach. 5,[12][13][14]18,34,35,41,43,44,57,59,64 Costotransversectomy was first described by Menard 48 in 1894 for drainage of tuberculous abscesses in patients with Pott paraplegia. Various modifications of this procedure have been developed for removal of anterior thoracic disc herniation, 32,33,40,56,62 traumatic lesions, 40 and metastatic tumors of the spine.…”

Section: Discussionmentioning

confidence: 99%

Perioperative complications with costotransversectomy and anterior approaches to thoracic and thoracolumbar tumors

Wiggins¹,

Mirza²,

Bellabarba³

et al. 2001

FOC

View full text Add to dashboard Cite

Object Anterior decompression and stabilization for thoracic spinal tumors often involves a thoracotomy and can be associated with surgical approach–related complications. An alternative to thoracotomy is surgery via a costotransversectomy exposure. To delineate the risks of surgery, the authors reviewed their prospective database for patients who had undergone surgery via either of these approaches for thoracic or thoracolumbar tumors. The complications were recorded and graded based on severity and risk of impact on patient outcome. Methods Between September 1995 and April 2001, the authors performed 29 costotransversectomies (Group 1) and 18 thoracolumbar or combined (Group 2) approaches as initial operations for thoracic neoplasms. The age, sex, pre-operative motor score, and preoperative Frankel grade did not significantly differ between the groups. In the costotransversectomy group there were greater numbers of metastases, upper thoracic procedures, and affected vertebral levels; additionally, the comorbidity rate based on Charlson score, was higher. The mean Frankel grades at discharge were not significantly different whereas the discharge motor and last follow-up motor scores were better in Group 2. There were 11 Group 1 and seven Group 2 patients who suffered at least one complication. The number or patients with complications, the mean number of complications, and severity of complications did not differ between the groups. Conclusions Compared with anterior or combined approaches, the incidence and severity of perioperative complications in the surgical treatment of thoracic and thoracolumbar spinal tumors is similar in patients who undergo costotransversectomy. Costotransversectomy may be the preferred operation in patients with significant medical comorbidity or tumors involving more than one thoracic vertebra.

show abstract

Section: Discussionmentioning

confidence: 99%

Perioperative complications with costotransversectomy and anterior approaches to thoracic and thoracolumbar tumors

Wiggins¹,

Mirza²,

Bellabarba³

et al. 2001

FOC

View full text Add to dashboard Cite

show abstract

“…31 A number of authors have described techniques for resecting spinal metastasis that do not require a transcavitary approach. 2,[6][7][8][9][16][17][18]21,23,24,29,31,36 A more limited, unilateral transpedicular technique without reconstruction or stabilization has been advocated for debilitated patients with spinal metastasis. 50 The patients in this study were considered poor candidates for a lateral operation because of their physical condition, the tumor's location, or both; thus a posterolateral approach for the removal of the metastasis and the associated reconstruction was applied.…”

Section: Choice Of Operative Approach and Techniquementioning

confidence: 99%

“…Series of patients treated with posterolateral transpedicular resection of spinal metastases combined with reconstruction and posterior stabilization have previously been reported. 2,9,16,18,21,23,24,31 However, our series of patients differs in a number of important ways (Table 4). All previous studies comprised mixtures of patients who either had a variety of tumor types (such as primary vs. metastatic, tumors of reticuloendothelial origin vs. tumors of solid organs) 9,21 or who underwent a variety of surgical techniques 2,18,21 and spinal fixation methods.…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

“…The goal of some authors was neural decompression alone, 21 whereas others attempted complete resection in only a fraction of their patients. 2,9,16,18,23,24,31 Reconstruction of the spine ranged in extent from none at all to bone grafting to complete reconstruction with MMA. Bridwell, et al, 2 did not perform vertebral reconstruction in any of their patients.…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Single-stage posterior vertebrectomy and replacement combined with posterior instrumentation for spinal metastasis

Akeyson¹,

McCutcheon²

1996

Journal of Neurosurgery

190

101

View full text Add to dashboard Cite

The authors present a series of 25 patients who underwent single-stage complete spondylectomy, vertebral body reconstruction, and posterior segmental spinal stabilization for malignant metastatic disease involving multiple columns of the thoracolumbar spine. Patients were selected for this approach primarily because they were poor candidates for a transcavitary or lateral extracavitary approach or because the tumor involved both anterior and posterior columns of the spine. The operative approach used combines radical local resection of tumor via a bilateral transpedicular route, methylmethacrylate vertebral body reconstruction, and Luque rectangle stabilization in a single operation. Following surgery, the majority of patients experienced improvement in their neurological status, reduction in pain, or both. Most patients were functionally improved, or at least no worse, and spinal alignment was maintained in all. There was one local recurrence in a long-term survivor. Complications included cerebrospinal fluid fistulas, migrating graft material, and wound healing problems. The authors conclude that this surgical approach is safe and feasible for the radical resection of vertebral metastasis when combined with reconstruction and stabilization. This technique represents a useful alternative to other commonly used surgical approaches for the treatment of spinal metastases, and it should aid surgeons in selecting the optimum approach for individual patients.

show abstract

“…The technique, and also the types of reconstruction of the anterior spine have undergone changes during this period, from non-reconstruction, using only rigid posterior fixation, to the use of methylmetacrylate molds, and even cage-type vertebral replacements, which are now expandible. 7,[9][10][11][12][13] The objective of this article is to present the results and complications of the initial series of patients to undergo posterior vertebrectomy and circumferential reconstruction at a service, after two years of follow-up.…”

Section: Introductionmentioning

confidence: 99%

Results and complications of vertebrectomy with posterior approach after 2-year follow-up

Silva

Daher

Esperidião³

et al. 2015

Coluna/Columna

View full text Add to dashboard Cite

Objective: To describe the surgical technique for vertebrectomy by posterior single approach in the thoracic and thoracolumbar spine with circumferential reconstruction and arthrodesis, and evaluate retrospectively the results and complications after 2 years of follow-up in patients undergoing this technique. Methods: Retrospective analysis of medical records and imaging studies of 12 patients with vertebrectomy indication for various pathologies, undergoing this surgical technique. Results: Eight (66.67%) patients were male and four patients (33.33%) were females aged 13-66 years (mean 40 years). There were nine patients with involvement of the thoracic spine and three of the lumbar, and one patient with two consecutive vertebrae affected. All patients had improved or remained with the neurological condition. Surgical complications were two cases of hemothorax, two cases of loosening of the screws, one of them requiring surgical revision, and a case of material failure and pseudarthrosis. Conclusion: Vertebrectomy by posterior approach in thoracolumbar spine with circumferential reconstruction and fusion can be performed safely for a variety of indications.

show abstract

Operative treatment of thoraco-lumbar metastases, using methylmetacrylate and Kempf's rods for vertebral replacement and stabilization

Cited by 9 publications

References 30 publications

Perioperative complications with costotransversectomy and anterior approaches to thoracic and thoracolumbar tumors

Perioperative complications with costotransversectomy and anterior approaches to thoracic and thoracolumbar tumors

Single-stage posterior vertebrectomy and replacement combined with posterior instrumentation for spinal metastasis

Results and complications of vertebrectomy with posterior approach after 2-year follow-up

Contact Info

Product

Resources

About