Outcomes and cost-minimization analysis of cement spacers versus expandable cages for posterior-only reconstruction of metastatic spine corpectomies

Jordan, Yusef J.; Buchowski, Jacob M.; Mokkarala, Mahati; Peters, Colleen; Bumpass, David B.

doi:10.21037/atm.2019.05.07

Cited by 10 publications

(6 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Einer der Hauptvorteile von Knochenzement ist neben den geringeren Kosten die Möglichkeit, die Zementplombe direkt dem knöchernen Defekt nach Resektion anpassen zu könnenselbst wenn dieser von der geplanten Größe abweicht [20]. Der Knochenzement kann dabei allein oder in Kombination mit Steinmann-Nägeln [21] oder einer Drahtmatrix [22] implantiert werden.…”

Section: Wirbelkörperersatz Mit Knochenzementunclassified

See 1 more Smart Citation

Stellenwert der Zementaugmentation in der Tumorchirurgie der Wirbelsäule

Osterhoff,

Heyde

2023

Die Wirbelsäule

View full text Add to dashboard Cite

ZusammenfassungDie Wirbelsäule ist nach Leber und Lunge einer der wichtigsten Manifestationsorte für metastasierende Tumor-Erkrankungen. Metastasen der Wirbelsäule können zu Schmerzen, neurologischen Ausfällen und eingeschränkter Lebensqualität führen. Die Augmentation der befallenen Wirbelkörper mit Knochenzement hat sich als wirksame Behandlungsoption zur Schmerzbehandlung, Stabilisierung und Verbesserung der funktionellen Ergebnisse bei Patienten erwiesen. Weitere Anwendungen von Knochenzement in der Tumorchirurgie der Wirbelsäule sind die Augmentation von Pedikelschrauben und der Wirbelkörperersatz, selten auch bei der operativen Behandlung von Primärtumoren.Ziel dieser Übersichtsarbeit ist es, einen umfassenden Überblick über die aktuelle Evidenz zur Verwendung von Knochenzement in der Tumorchirurgie der Wirbelsäule zu geben, einschließlich Indikationen, Techniken, Ergebnissen und potenziellen Komplikationen.

show abstract

Section: Wirbelkörperersatz Mit Knochenzementunclassified

“…In einer Serie rein posteriorer Korpektomien für Wirbelsäulenmetastasen, die mit PMMA rekonstruiert wurden, boten PMMA-Spacer die gleiche Stabilität und Langlebigkeit wie expandierbare Cages [20]. Auch funktionell und hinsichtlich der Kyphosekorrektur bestehen keine signifikanten Unterschiede [23].…”

Section: Wirbelkörperersatz Mit Knochenzementunclassified

Stellenwert der Zementaugmentation in der Tumorchirurgie der Wirbelsäule

Osterhoff,

Heyde

2023

Die Wirbelsäule

View full text Add to dashboard Cite

show abstract

“…46 Over the past two decades, the use of cement using fenestrated screws has proven to be safe, efficacious, and has expanded which patients may be successfully treated with surgery. 47,48 Figure 4, Panel A demonstrates the use of cement using fenestrated screws in a patient with multiple myeloma who went from near nonambulatory back to ambulating and even working again, now more than 1-year postoperative. Figure 4, Panel B demonstrates the combined efforts of surgical and interventional use of cement to treat a patient with metastatic endocrine cancer and multiple symptomatic spinal lesions.…”

Section: Surgerymentioning

confidence: 99%

Spinal Tumors: Diagnosis and Treatment

Goodwin

Buchowski

Schwab

et al. 2022

J Am Acad Orthop Surg

Self Cite

View full text Add to dashboard Cite

Tumors that present in or around the spine can be challenging to diagnose and treat. A proper workup involves a complete history and physical examination, appropriate staging studies, appropriate imaging of the entire spine, and a tissue biopsy. The biopsy defines the lesion and guides treatment, but in some rare instances, rapid neurological decline may lead to urgent or emergent surgery before it can be analyzed. “Enneking-appropriate” margins should remain the goal for primary tumors while adequate debulking/separation/stabilization are often the goals in metastatic disease. Primary tumors of the spine are rare and often complex tumors to operate on—achieving Enneking-appropriate margins provides the greatest chance of survival while decreasing the chance of local recurrence. Metastatic tumors of the spine are increasingly more common, and timing of surgery must be considered within the greater framework of the patient and the patient's disease, deficits, stability, and other treatments available. The specific tumor type will dictate what other multidisciplinary approaches are available, allowing for chemotherapy and radiation as needed.

show abstract

“…As a result, current literature remains inconclusive regarding the overall efficacy of expandable compared to static implants [ 7 , 9 , 11 ]. Furthermore, expandable cages are frequently more expensive, with some costing as much as $5,000 [ 17 ], prompting some to question whether expandable cages have a favorable cost–benefit ratio in today’s value-based decision-making environment.…”

Section: Introductionmentioning

confidence: 99%

Static versus Expandable Interbody Fusion Devices: A Comparison of 1-Year Clinical and Radiographic Outcomes in Minimally Invasive Transforaminal Lumbar Interbody Fusion

et al. 2023

View full text Add to dashboard Cite

To compare the radiographic and clinical outcomes of static versus expandable interbody cages in transforaminal lumbar interbody fusion using minimally invasive surgery (MIS-TLIF). Overview of Literature: Expandable interbody cages may potentially improve radiographic and clinical outcomes following MIS-TLIF compared to static pages, but at a potentially higher cost and increased rates of subsidence. Methods: A retrospective chart review of 1-and 2-level MIS-TLIFs performed from 2014 to 2020 was reviewed. Radiographic measurements were obtained preoperatively, 6 weeks postoperatively, and at final follow-up. Patient-reported outcome measures (PROMs) including the Oswestry Disability Index, Visual Analog Scale (VAS) back, and VAS leg were evaluated. Multivariate linear regression analysis determined the effect of cage type on the change in PROMs, controlling for demographic characteristics. Alpha was set at 0.05. Results: A total of 221 patients underwent MIS-TLIF including 136 static and 85 expandable cages. Expandable cages had significantly greater anterior (static: 11.41 mm vs. expandable: 13.11 mm, p<0.001) and posterior disk heights (static: 7.22 mm vs. expandable: 8.11 mm, p<0.001) at 1-year follow-up. Expandable cages offered similar improvements in segmental lordosis at 6 weeks (static: 1.69° vs. expandable: 2.81°, p=0.243), but segmental lordosis was better maintained with expandable cages leading to significant differences at 1-year follow-up (static: 0.86° vs. expandable: 2.45°, p=0.001). No significant differences were noted in total complication (static: 12.5% vs. expandable: 16.5%, p=0.191) or cage subsidence rates (static: 19.7% vs. expandable: 22.4%, p=0.502) groups at 1-year follow-up. Conclusions: Expandable devices provide greater improvements in radiographic measurements including anterior disk height, posterior disk height, and segmental lordosis, but this did not lead to significant improvements in PROMs, complication rates, subsidence rates, or subsidence distance.

show abstract

Outcomes and cost-minimization analysis of cement spacers versus expandable cages for posterior-only reconstruction of metastatic spine corpectomies

Abstract: Outcomes and cost-minimization analysis of cement spacers versus expandable cages for posterior-only reconstruction of metastatic spine corpectomies." Annals of Translational Medicine.,. .

Cited by 10 publications

References 15 publications

Stellenwert der Zementaugmentation in der Tumorchirurgie der Wirbelsäule

Stellenwert der Zementaugmentation in der Tumorchirurgie der Wirbelsäule

Spinal Tumors: Diagnosis and Treatment

Static versus Expandable Interbody Fusion Devices: A Comparison of 1-Year Clinical and Radiographic Outcomes in Minimally Invasive Transforaminal Lumbar Interbody Fusion

Contact Info

Product

Resources

About