Total spondylectomy for the treatment of spinal tumors

Ардашев, И. П.; Рерих, В. В.; Tsivyan, Orthopaedics n.a. Ya.L.

doi:10.14531/ss2009.1.49-56

Cited by 3 publications

(1 citation statement)

References 20 publications

(34 reference statements)

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“…В литературе есть описания случаев применения методики вертебротомии en bloc по Tomita, иначе VCR -vertebral column resection или TES -total en bloc spondylectomy (рис. 1), с последующей инструментальной фиксацией позвоночника при гигантоклеточной опухоли позвонка, а также при тяжелых кифотических деформациях позвоночника [1,9]. Однако использование данной методики у больных с последствиями тяжелой ПСМТ в литературе не отражено.…”

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Vertebral Column Resection Technique to Treat Sequelae of Severe Spine and Spinal Cord Injury

Ryabykh¹,

Хомченков²,

Savin³

2013

Hir. pozvonoč.

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Vertebral Column Resection Technique to Treat Sequelae of Severe Spine and Spinal Cord Injury

Ryabykh¹,

Хомченков²,

Savin³

2013

Hir. pozvonoč.

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Surgical methods in management of metastatic spinal cord lesions

Ermolaev

Yarikov

Aleynik

et al. 2022

Nejrohirurgiâ (Mosk.)

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Malignant neoplasms remain the leading cause of death worldwide. The spine is a target for metastasis more often than other skeletal bones. This article details the principles of diagnosis, treatment, and the clinical picture of secondarylesions of the spinal column. The causes of pain syndrome in cancerous lesions of the spine are reviewed: compression of nerve structures, pathological fractures, spinal instability, lytic foci and paraneoplastic pain syndrome. The causes and patterns of each type of pain syndrome are described in detail. The article presents the scales used to predict the life expectancy of these patients: Tokuhashi, Tomita and Bauer. The effectiveness of these scales is compared. The selection criteria for surgical treatment of patients with metastatic lesions of the spine are described in detail. Modern methods of surgical treatment of secondary lesions of the spinal column are presented: palliative, subtotal, total (enblock resections). The indications and contraindications for each type of surgical treatment are described. Methods of intraoperative hemostasis are described, with the special attention given to preoperative tumor embolization. The errors and complications of this technique are described in detail. The correlation dependence of intraoperative blood loss volume on the embolization terms is presented. Modern trends in the development of surgical methods in metastatic spinal tumors are described in conclusion.

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Prognostic value of the Tokuhashi scale when choosing a method of surgical treatment of metastatic lesions of the spine

Kosimshoev

Evsyukov

Kubetskiy

et al. 2021

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Introduction. Metastatic spinal lesion remains one of the most difficult problems of modern medicine. The purpose of treatment of patients with metastatic spinal lesion is to reduce pain, improve the quality of life, restore stability in the affected segment, prevent or reduce neurological deficits. In order to build the right treatment tactics, it is necessary to evaluate the prognosis of the life of a patient with spinal metastases before treatment.The study objective is to evaluate the prognostic significance of the Tokuhashi scale in patients with metastatic spinal lesion.Materials and methods. The study included 124 patients with metastatic spinal lesion operated in the spinal department in the period from March 2013 to July 2019 (64 (52 %) men and 60 (48%) women). The average age was 59 years and ranged from 18 to 78 years. The catamnesis ranged from 1 month to 6 years. 6 (5 %) spinal tumors were radically removed, palliative removal was performed in 77 (62 %) cases. In the remaining cases, 41 (33 %) underwent vertebroplasty. The mandatory diagnostic protocol of the preoperative examination included oncological status, clinical and neurological examination. The functional status of the patient was assessed on the Karnofski scale, life expectancy – on the Tokuhashi scale. In terms of preoperative examination, patients underwent computed tomography examination with intravenous contrast of three zones: the thoracic, abdominal cavities and pelvic region to determine the degree of dissemination of the process and, in some cases, to identify the primary focus. Currently, positron emission tomography is the optimal method of investigation at the preoperative stage. However, this method is not yet available in all clinics, so performing computed tomography scans of three zones is currently the optimal “gold standard” for examining this category of patients..Results. The life expectancy estimate was calculated for each patient according to the Tokuhashi scale (2005). Survival analysis was performed using Kaplan-Meier curves within the Tokuhashi prognostic groups. The median survival within the Tokuhashi groups was more than 3 years for the group of 12–15 points (life expectancy over a year), 14 months for the group of 9–11 points (life expectancy 6 to 12 months) and 7 months for the group of 1–8 points (life expectancy less than 6 months). The Cox model was used to identify factors related to survival.Conclusion. Determining the tactics of surgical treatment of a patient with a metastatic lesion of the spine is a complex and multicomponent question to which there is no unambiguous answer. A multidisciplinary consultation is currently the most adequate and reliable way to determine the treatment strategy for this category of patients. The use of the Tokuhashi prognostic scale is an additional effective tool for determining the life expectancy of patients with spinal metastases, and thus, in some cases, serve as the tool with which it is possible to determine the tactics of surgical treatment of patients.

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Total spondylectomy for the treatment of spinal tumors

Abstract: Literature review on surgical treatment of spinal tumors is presented. One-stage spondylectomy was described and spinal tumor resection through a total en block spondylectomy was presented in details based on the results of scientific studies performed between 1953 and 2007.

Cited by 3 publications

References 20 publications

Vertebral Column Resection Technique to Treat Sequelae of Severe Spine and Spinal Cord Injury

Vertebral Column Resection Technique to Treat Sequelae of Severe Spine and Spinal Cord Injury

Surgical methods in management of metastatic spinal cord lesions

Prognostic value of the Tokuhashi scale when choosing a method of surgical treatment of metastatic lesions of the spine

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