Total En Bloc Spondylectomy for Solitary Metastatic Tumors of the Fourth Lumbar Spine in a Posterior-Only Approach

Huang, Wending; Wei, Haifeng; Cai, Weiluo; Xu, Wei; Yang, Xinghai; Liu, Tielong; Wu, Zhipeng; Huang, Quan; Yan, Wangjun; Xiao, Jianru

doi:10.1016/j.wneu.2018.06.251

Cited by 21 publications

(17 citation statements)

References 29 publications

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“…Because the anatomical structure of the spine is complex, radical spinal oncology resection for spinal neoplasms is nearly impossible [22,23]. Although piecemeal or intralesional excisions may yield the complete resection of tumors, these procedures are associated with a high risk of local recurrence due to tumor contamination and residual tumors [24].…”

Section: Discussionmentioning

confidence: 99%

Total en bloc spondylectomy combined with the satellite rod technique for spinal tumors

Wei

Dong

et al. 2020

J Orthop Surg Res

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Background Instrumentation failure (IF) is a common complication after total en bloc spondylectomy (TES) in spinal tumors. This study aims to evaluate the clinical outcomes of TES combined with the satellite rod technique for the treatment of primary and metastatic spinal tumors. Methods The clinical data of 15 consecutively treated patients with spinal tumors who underwent TES combined with the satellite rod technique by a single posterior approach from June 2015 to September 2018 were analyzed retrospectively. Radiographic parameters including the local kyphotic angle (LKA), anterior vertebral height (AVH), posterior vertebral height (PVH), and intervertebral titanium mesh cage height (ITMCH) were assessed preoperatively, postoperatively, and at the final follow-up. The visual analog scale (VAS), Oswestry Disability Index (ODI), and American Spinal Injury Association (ASIA) scale were used to assess quality of life and neurological function. The operative duration, volume of blood loss, and complications were also recorded. Results The mean operation time and volume of blood loss were 361.7 min and 2816.7 mL, respectively. During an average follow-up of 31.1 months, 2 patients died of tumor recurrence and multiple organ metastases, while recurrence was not found in any other patients. Solid fusion was achieved in all but one patient, and no implant-related complications occurred during the follow-up. The VAS, ODI, and ASIA scores significantly improved from before to after surgery (P < 0.05). The LKA, AVH, and PVH significantly improved from before to immediately after surgery and to the final follow-up (P < 0.05), and the postoperative and final follow-up values did not significantly differ (P > 0.05). Conclusions TES combined with the satellite rod technique can yield strong three-dimensional fixation and reduce the occurrence of rod breakage, thereby improving the long-term quality of life of patients with spinal tumors.

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Section: Discussionmentioning

confidence: 99%

Total en bloc spondylectomy combined with the satellite rod technique for spinal tumors

Wei

Dong

et al. 2020

J Orthop Surg Res

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show abstract

“…Because the anatomical structure of the spine is complex, radical spinal oncology resection for spinal neoplasms is nearly impossible [18,19]. Although piecemeal or intralesional excisions may yield the complete resection of tumors, these procedures are associated with a high risk of local recurrence due to tumor contamination and residual tumors [20].…”

Section: Discussionmentioning

confidence: 99%

Total En Bloc Spondylectomy Combined with the Satellite Rod Technique for Spinal Tumors

Wei

Dong

et al. 2020

Preprint

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Background: To evaluate the clinical outcomes of total en bloc spondylectomy (TES) combined with the satellite rod technique for the treatment of primary and metastatic spinal tumors.Methods: The clinical data of 15 consecutively treated patients with spinal tumors who underwent TES combined with satellite rod technique by a single posterior approach from June 2015 to September 2018were analyzed retrospectively. Radiographic parameters including the local kyphotic angle (LKA), anterior vertebral height (AVH), posterior vertebral height (PVH) and intervertebral titanium mesh cage height (ITMCH) were assessed preoperatively, postoperatively and at the final follow-up. The visual analog scale (VAS), Oswestry Disability Index (ODI) and American Spinal Injury Association (ASIA) scale were used to assess quality of life and neurological function. The operative duration, volume of blood loss, and complications were also recorded.Results: The mean operation time and volume of blood loss were 361.7 min and 2816.7 mL, respectively. During an average follow-up of 31.1 months, 2 patients died of tumor recurrence and multiple organ metastases, while recurrence was not found in any other patients. Solid fusion was achieved in all but one patient, and no implant-related complications occurred during the follow-up. The VAS, ODI and ASIA scores significantly improved from before to after surgery (P<0.05). The LKA, AVH and PVH significantly improved from before to immediately after surgery and to the final follow-up (P<0.05), and the postoperative and final follow-up values did not significantly differ (P>0.05).Conclusions: TES combined with the satellite rod technique can yield strong three-dimensional fixation and reduce the occurrence of rod breakage, thereby improving the long-term quality of life of patients with spinal tumors.

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“…Presently, total en bloc spondylectomy (TES) has been increasingly recognized, and widely accepted for the treatment of specific spine tumors and has better tumor control than piecemeal and subtotal resection. 38 , 39 In our series, the resection mode included total en bloc spondylectomy, total piecemeal spondylectomy and debulking or subtotal resection, which technique to use was mainly based on the Tomita classification and WBB staging. The final statistical results revealed that TES resulted in better OS than those treated with piecemeal and subtotal mode (p=0.029, 95% CI 1.136–6.421, Figure 6 ).…”

Section: Discussionmentioning

confidence: 99%

<p>Surgical Treatment Outcomes of Spinal Metastases of Nasopharyngeal Carcinoma: The First Report of 30 Patients from a Single Center</p>

Yang¹,

Hu²,

Wang³

et al. 2020

CMAR

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Background Studies focused on surgical interventions of spinal metastases of nasopharyngeal carcinoma (SMNPC) are blank. Methods Patients with SMNPC who received surgical treatment in our center between 2005 and 2017 were included. Univariate and multivariate analysis of various clinical characteristics and operation-related data were analyzed to identify the independent factors that affected prognosis. Factors with P values of 0.1 or less were subjected to multivariate Cox regression analysis. P values of 0.05 or less were considered statistically significant. Results A total of 30 patients with SMNPC treated with surgery were included. The thoracic spine was the most frequently involved site. The patients in this series achieved good overall survival (OS, 20.26 months) with limited perioperative complications. The univariate analysis suggested that preoperative Karnofsky performance scale, number of spinal metastases, number of visceral metastases, preoperative Frankel score, surgical resection mode and Ki 67 were potential prognostic factors. In the multivariate analyses, number of visceral metastases, preoperative Frankel score and resection mode were found to be independent prognostic factors. Conclusion This is the first study focusing on surgical outcomes in SMNPC. The thoracic spine was the most frequently involved site of SMNPC. Preoperative Frankel score, number of visceral metastasis and surgical resection mode were independent prognostic factors for SMNPC. Combined with adjuvant therapies, surgical interventions should be recommended early when necessary.

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Total En Bloc Spondylectomy for Solitary Metastatic Tumors of the Fourth Lumbar Spine in a Posterior-Only Approach

Cited by 21 publications

References 29 publications

Total en bloc spondylectomy combined with the satellite rod technique for spinal tumors

Total en bloc spondylectomy combined with the satellite rod technique for spinal tumors

Total En Bloc Spondylectomy Combined with the Satellite Rod Technique for Spinal Tumors

<p>Surgical Treatment Outcomes of Spinal Metastases of Nasopharyngeal Carcinoma: The First Report of 30 Patients from a Single Center</p>

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