Total en bloc spondylectomy is worth doing in complete paralysis spinal giant cell tumor, a minimum 1-year follow-up

Objective: To investigate the neurological recovery of Frankel A spinal giant cell tumor (GCT) patients after they had received a Total En Bloc Spondylectomy (TES). Materials and Methods: We retrospectively recorded data of three patients (two females) with mobile spine GCT (T6, T10, and L2) Enneking stage III with complete paralysis before surgery, who had undergone TES in our institute from January 2018 to September 2020. The duration of neurologic recovery to Frankel E was the primary outcome. The intra-operative blood loss, operative time, operative-related complications, and the local recurrence were the secondary outcomes. Results: The duration of suffering from Frankel A to TES surgery was 2 months for the T6 patient, 3 weeks for the T10 patient, and 1 month for the L2 patient. Three patients had achieved full neurological recovery to Frankel E within 6 months after TES (T6 for 5 months, T10 for 3 months, and L2 for 3 months). The average blood loss was 2833.33 ml and the mean operative time was 400 min. Up until the last follow-up (13–25 months), no evidence of local recurrences had been found in any of the three patients. Conclusion: Frankel A spinal GCT patients can achieve full neurological recovery after TES, if the procedure is performed within 3 months after complete paraplegia. TES can effectively control any local recurrences.

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

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-02058-x ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Hongyu Wei ◽

Chunke Dong ◽

Jun Wu ◽

Yuting Zhu ◽

Haoning Ma

Keyword(s):

Quality Of Life ◽

Blood Loss ◽

Spinal Tumors ◽

Vertebral Height ◽

En Bloc ◽

Total En Bloc Spondylectomy ◽

En Bloc Spondylectomy ◽

Bloc Spondylectomy

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

10.21203/rs.3.rs-60470/v2 ◽

2020 ◽

Author(s):

Hongyu Wei ◽

Chunke Dong ◽

Jun Wu ◽

Yuting Zhu ◽

Haoning Ma

Keyword(s):

Quality Of Life ◽

Blood Loss ◽

Spinal Tumors ◽

Vertebral Height ◽

En Bloc ◽

Total En Bloc Spondylectomy ◽

En Bloc Spondylectomy ◽

Bloc Spondylectomy

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

10.21203/rs.3.rs-60470/v1 ◽

2020 ◽

Author(s):

Hongyu Wei ◽

Chunke Dong ◽

Jun Wu ◽

Yuting Zhu ◽

Haoning Ma

Keyword(s):

Quality Of Life ◽

Blood Loss ◽

Spinal Tumors ◽

Vertebral Height ◽

En Bloc ◽

Total En Bloc Spondylectomy ◽

En Bloc Spondylectomy ◽

Bloc Spondylectomy

Abstract 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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More than 10-year follow-up after total en bloc spondylectomy for spinal tumors.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.15_suppl.e21503 ◽

2014 ◽

Vol 32 (15_suppl) ◽

pp. e21503-e21503

Author(s):

Satoshi Kato ◽

Hideki Murakami ◽

Satoru Demura ◽

Katsuhito Yoshioka ◽

Hiroyuki Hayashi ◽

...

Keyword(s):

Spinal Tumors ◽

En Bloc ◽

Total En Bloc Spondylectomy ◽

En Bloc Spondylectomy ◽

Bloc Spondylectomy

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130. Effect of Preoperative Embolization of Bilateral Segmental Arteries at Multiple (Up to Three) Levels on Intraoperative Blood Loss in Total En Bloc Spondylectomy

The Spine Journal ◽

10.1016/j.spinee.2008.06.160 ◽

2008 ◽

Vol 8 (5) ◽

pp. 67S-68S

Author(s):

Norio Kawahara ◽

Katsuro Tomita ◽

Hideki Murakami ◽

Satoru Demura ◽

Junichiro Sanada ◽

...

Keyword(s):

Blood Loss ◽

Preoperative Embolization ◽

Intraoperative Blood Loss ◽

En Bloc ◽

Total En Bloc Spondylectomy ◽

En Bloc Spondylectomy ◽

Bloc Spondylectomy ◽

Segmental Arteries

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Total en bloc spondylectomy for solitary spinal metastases

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto64216 ◽

1996 ◽

Vol 3 (2) ◽

pp. 11-18

Author(s):

K. Tomita ◽

N. Kawahara ◽

H. Baba ◽

H. Tsuchiya ◽

S. Nagata ◽

...

Keyword(s):

Spinal Metastases ◽

Lumbar Vertebrae ◽

En Bloc Resection ◽

Bloc Resection ◽

En Bloc ◽

Wide Margin ◽

Total En Bloc Spondylectomy ◽

En Bloc Spondylectomy ◽

Bloc Spondylectomy

We have developed a technique for total en bloc spondylectomy through a posterior approch and now report our experience of 20 patients with a solitary or localised metastasis in the thoracic or lumbar vertebrae. There are two steps: an en bloc laminectomy, followed by en bloc resection of the vertebral body with an oncological wide margin and the insertion of a vertebral prosthesis. Pain was relieved in the 17 patients who could be assessed; 11 of the 15 patients with a neurological deficit were much improved, impending paralysis being prevented in 5 patients. There have been no local recurrences. Nine patients are at present alive with a mean follow up of 17,4 months.

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