Risk factor analysis for progressive spinal deformity after resection of intracanal tumors─ a retrospective study of 272 cases

Wang, Pangbo; Ma, Kang; Chen, Tunan; Xue, Xingsen; Ma, Dada; Wang, Shi; Chen, Xin; Meng, Hui; Cui, Gaoyu; Gao, Boyuan; Lin, Jiangkai; Feng, Hua; Chu, Weihua

doi:10.1186/s12883-019-1594-x

Cited by 10 publications

(7 citation statements)

References 20 publications

(28 reference statements)

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“…The advantages of UBE include less damage to the paraspinal musculature, smaller wounds, and better surgical vision. ( 23 , 24 ) The major challenges in UBE are establishing suitable saline irrigation, minimizing complications, and properly localizing the surgical region ( 25 , 26 ).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of unilateral biportal endoscopy versus other spine surgery: A systematic review and meta-analysis

Zheng

Xu²,

Chen³

et al. 2022

Front. Surg.

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BackgroundThis study aimed to evaluate the efficacy and safety of unilateral biportal endoscopy (UBE) versus other forms of spine surgery.MethodsElectronic databases were systematically searched up to February 2022. The authors used Review Manager 5.3 to manage the data and perform the review.ResultsAfter the preliminary selection of 239 studies from electronic databases, the full inclusion criteria were applied; 16 studies were found to be eligible for inclusion. These 16 studies enrolled 1,488 patients: 653 patients in the UBE group, 570 in the microendoscopic discectomy group, 153 in the percutaneous endoscopic lumbar discectomy group, and 70 in the posterior lumbar interbody fusion group. UBE was superior to microendoscopic discectomy regarding 1-day Visual Analog Scale(VAS) back pain scores (P < 0.00001). No difference was found between UBE and microendoscopic discectomy regarding 1-day Visual Analog Scale leg pain scores (P = 0.25), long-term VAS back pain scores (P = 0.06), long-term VAS leg pain scores (P = 0.05), Oswestry Disability Index scores (P = 0.09) or complications (P = 0.19). Pooled analysis indicated that UBE was similar to percutaneous endoscopic lumbar discectomy regarding 1-day VAS back pain scores (P = 0.71), 1-day VAS leg pain scores (P = 0.37), long-term VAS back pain scores (P = 0.75), long-term VAS leg pain scores (P = 0.41), Oswestry Disability Index scores (P = 0.07) and complications (P = 0.88). One study reported no difference between UBE and posterior lumbar interbody fusion regarding long-term VAS back pain, long-term VAS leg pain, or Oswestry Disability Index scores.ConclusionsUBE is superior to microendoscopic discectomy to relieve back pain 1 day postoperatively. However, these two procedures are similar regarding 1-day leg pain relief, long-term effects, and safety. UBE and percutaneous endoscopic lumbar discectomy are similar regarding 1-day pain relief, long-term effects and safety. More evidence is needed to evaluate the efficacy and safety of UBE versus posterior lumbar interbody fusion.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of unilateral biportal endoscopy versus other spine surgery: A systematic review and meta-analysis

Zheng

Xu²,

Chen³

et al. 2022

Front. Surg.

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“…Management after resection will involve close clinical and radiologic follow-up and continued bracing, as the authors have concern for the long-term development of a progressive deformity. A recent retrospective review of 272 cases of intracanal tumor resection found the incidence of postoperative progressive spinal deformity to be 15.8% [ 21 ]. This occurred mostly in patients who had younger age (≤18 years) or tumors that involved multiple segments and preoperative spinal deformity.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Extramedullary Epidural Spinal Teratomas: A Case Report and Review of the Literature

Deckey

Fernandez

Lara

et al. 2021

Case Reports in Orthopedics

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Background. Teratomas in the pediatric population are most commonly found in the sacrococcygeal region. Pediatric intraspinal teratomas, however, are an exceedingly rare central nervous system (CNS) neoplasm. The clinical presentation of these intraspinal neoplasms can vary significantly and thus can be difficult to identify in infants less than one year of age where verbal expression and motor development are still lacking. Case Description. A 7-month-old, previously healthy male presented with a thoracic scoliosis and an asymptomatic right midupper thoracic spinal prominence present since birth. MRI revealed an extensive heterogenous mass in the right epidural space from T5-T6 and the right paravertebral space, resulting in severe spinal stenosis. Outcome. Complete resection of the tumor, including a three-level neurotomy, was achieved by posterior decompression/laminectomy. The final tumor was consistent with a mature teratoma. The surgical resection was performed without any immediate complications. Conclusions. Extramedullary epidural teratomas are exceptionally rare tumors in the pediatric population. Clinical presentation can be ambiguous, particularly in an infant. MRI was useful in suggesting a teratoma as a potential diagnosis and for postoperative surveillance for recurrence. However, histopathological analysis remains the gold standard for definitive diagnosis. Surgical resection is the mainstay of treatment, especially in the setting of cord compression and progressive loss of motor function. Close follow-up is crucial to monitor for progressive spinal deformity or recurrence.

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“…Lenke et al reported that the incidence of EP events was 27.0% in 147 cases of severe spinal deformity, while the incidence of neurological complications was 6.1% [ 13 ]. Several surgical factors are involved in the neurological complications that may arise from spinal surgery, including compression and traction of neural structures, osteotomy related injuries, hypotension, and spinal cord ischemia [ 5 – 7 , 14 , 15 ]. In total, 58 of 177 patients (32.8%) had EP events during the operation.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for neurological complications in severe and rigid spinal deformity correction of 177 cases

et al. 2020

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Background Difficult procedures of severe rigid spinal deformity increase the risk of intraoperative neurological injury. Here, we aimed to investigate the preoperative and intraoperative risk factors for postoperative neurological complications when treating severe rigid spinal deformity. Methods One hundred seventy-seven consecutive patients who underwent severe rigid spinal deformity correction were assigned into 2 groups: the neurological complication (NC, 22 cases) group or non-NC group (155 cases). The baseline demographics, preoperative spinal cord functional classification, radiographic parameters (curve type, curve magnitude, and coronal/sagittal/total deformity angular ratio [C/S/T-DAR]), and surgical variables (correction rate, osteotomy type, location, shortening distance of the osteotomy gap, and anterior column support) were analyzed to determine the risk factors for postoperative neurological complications. Results Fifty-eight patients (32.8%) had intraoperative evoked potentials (EP) events. Twenty-two cases (12.4%) developed postoperative neurological complications. Age and etiology were closely related to postoperative neurological complications. The spinal cord functional classification analysis showed a lower proportion of type A, and a higher proportion of type C in the NC group. The NC group had a larger preoperative scoliosis angle, kyphosis angle, S-DAR, T-DAR, and kyphosis correction rate than the non-NC group. The results showed that the NC group tended to undergo high-grade osteotomy. No significant differences were observed in shortening distance or anterior column support of the osteotomy area between the two groups. Conclusions Postoperative neurological complications were closely related to preoperative age, etiology, severity of deformity, angulation rate, spinal cord function classification, intraoperative osteotomy site, osteotomy type, and kyphosis correction rate. Identification of these risk factors and relative development of surgical techniques will help to minimize neural injuries and manage postoperative neurological complications.

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Risk factor analysis for progressive spinal deformity after resection of intracanal tumors─ a retrospective study of 272 cases

Cited by 10 publications

References 20 publications

Efficacy and safety of unilateral biportal endoscopy versus other spine surgery: A systematic review and meta-analysis

Efficacy and safety of unilateral biportal endoscopy versus other spine surgery: A systematic review and meta-analysis

Pediatric Extramedullary Epidural Spinal Teratomas: A Case Report and Review of the Literature

Risk factors for neurological complications in severe and rigid spinal deformity correction of 177 cases

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