Comparison of mini-open anterior corpectomy and posterior total en bloc spondylectomy for solitary metastases of the thoracolumbar spine

2012 ◽  
Vol 17 (4) ◽  
pp. 271-279 ◽  
Author(s):  
Taolin Fang ◽  
Jian Dong ◽  
Xiaogang Zhou ◽  
Robert A. McGuire ◽  
Xilei Li
Keyword(s):  
Local Recurrence ◽  
Blood Loss ◽  
Thoracolumbar Spine ◽  
En Bloc ◽  
Total En Bloc Spondylectomy ◽  
En Bloc Spondylectomy ◽  
Bloc Spondylectomy ◽  
Anterior Corpectomy ◽  
Solitary Metastases ◽  
Mini Open

Object The object of this study was to compare the mini-open anterior corpectomy procedure with posterior total en bloc spondylectomy (TES) in treating patients with solitary metastases of the thoracolumbar spine. Methods From 2004 to 2010, 41 patients with solitary metastases of the thoracolumbar spine were treated in our hospital using either a mini-open anterior corpectomy or posterior TES. Intraoperative and diagnostic data, including perioperative complications, were collected using retrospective chart review. The surgical outcomes were assessed according to survival status, neurological function, local recurrence, and pain before and after surgery. Results Seventeen patients underwent posterior TES and 24 underwent mini-open anterior corpectomy. Mean blood loss (TES, 1721 ± 293 ml; mini-open corpectomy, 1058 ± 263 ml; p < 0.05), and mean operative time (TES, 403 ± 55 minutes; mini-open corpectomy, 175 ± 38 minutes; p < 0.05) were recorded and calculated. Neurological improvement by at least 1 American Spinal Injury Association Impairment Scale grade was noted in 35 (97.2%) of the 36 cases with preoperative deficits. After the operation, 68.4% of nonambulatory patients became ambulatory again, including 84.6% after mini-open corpectomy and 33.3% after posterior TES (p > 0.05). The visual analog scale scores of the patients were significantly reduced after both procedures, with no difference between the procedures (p > 0.05). The local tumor recurrence rate of the TES group was significantly lower than that of the mini-open corpectomy group (p < 0.05), while the postoperative survival rates within 2 years after surgery were similar. The complication rate in the mini-open corpectomy group (29.2%) was higher than that in the TES group (11.8%), but this difference was not statistically significant (p = 0.185). There was no hardware failure and no loss of the sagittal Cobb angle in either group. Slight subsidence (< 3 mm) of the mesh cage was observed with a successful fusion in 3 (17.6%) of 17 patients in the TES group. No subsidence of polymethylmethacrylate block/autograft was recorded in the mini-open group. Conclusions Mini-open anterior corpectomy can be accomplished with less blood loss, fewer fixation instrumentations, and shorter surgical time than that required for TES, but patients who undergo a mini-open corpectomy might have a greater tendency to experience local recurrence. A mini-open anterior corpectomy has a relatively mild learning curve and involves fewer technical difficulties. With smaller incisions, mini-open anterior corpectomy is an option in treating solitary metastases of the thoracolumbar spine.

scholarly journals Primary malignant bone tumors and solitary metastases of the thoracolumbar spine: results by management with total en bloc spondylectomy

2007 ◽  
Vol 16 (8) ◽  
pp. 1193-1202 ◽  
Author(s):  
Ingo Melcher ◽  
Alexander C. Disch ◽  
Cyrus Khodadadyan-Klostermann ◽  
Stefan Tohtz ◽  
Mirko Smolny ◽  
...  
Keyword(s):  
Bone Tumors ◽  
Thoracolumbar Spine ◽  
Malignant Bone Tumors ◽  
En Bloc ◽  
Total En Bloc Spondylectomy ◽  
En Bloc Spondylectomy ◽  
Bloc Spondylectomy ◽  
Solitary Metastases

Risk factors for local recurrence after total en bloc spondylectomy for metastatic spinal tumors: A retrospective study

2018 ◽  
Vol 23 (3) ◽  
pp. 459-463 ◽  
Author(s):  
Takashi Igarashi ◽  
Hideki Murakami ◽  
Satoru Demura ◽  
Satoshi Kato ◽  
Katsuhito Yoshioka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Local Recurrence ◽  
Spinal Tumors ◽  
En Bloc ◽  
Total En Bloc Spondylectomy ◽  
En Bloc Spondylectomy ◽  
Bloc Spondylectomy

Outcome of Total En Bloc Spondylectomy for Solitary Metastasis of the Thoracolumbar Spine

2004 ◽  
Vol 17 (4) ◽  
pp. 297-300 ◽  
Author(s):  
Hironobu Sakaura ◽  
Noboru Hosono ◽  
Yoshihiro Mukai ◽  
Takahiro Ishii ◽  
Kazuo Yonenobu ◽  
...  
Keyword(s):  
Thoracolumbar Spine ◽  
En Bloc ◽  
Total En Bloc Spondylectomy ◽  
Solitary Metastasis ◽  
En Bloc Spondylectomy ◽  
Bloc Spondylectomy

Total en bloc spondylectomy for spinal metastases in thyroid carcinoma

2011 ◽  
Vol 14 (2) ◽  
pp. 172-176 ◽  
Author(s):  
Satoru Demura ◽  
Norio Kawahara ◽  
Hideki Murakami ◽  
Mohamed E. Abdel-Wanis ◽  
Satoshi Kato ◽  
...  
Keyword(s):  
Survival Rate ◽  
Local Recurrence ◽  
Thyroid Carcinoma ◽  
Spinal Metastases ◽  
Debulking Surgery ◽  
En Bloc ◽  
Total En Bloc Spondylectomy ◽  
En Bloc Spondylectomy ◽  
Bloc Spondylectomy ◽  
The Impact

Object Thyroid carcinoma generally has a favorable prognosis, and patients rarely present with distant metastases. Authors of several studies have proposed piecemeal resection for spinal metastases in thyroid carcinoma; however, few have analyzed the impact of local curative surgery such as total en bloc spondylectomy (TES) for thyroid carcinoma. The purposes of the present study are to determine the strategy of surgical treatment for spinal metastases of thyroid carcinoma and to evaluate the surgical results of and the prognosis associated with TES. Methods Twenty-four cases of spinal metastases were retrospectively reviewed. The patients included 16 women and 8 men, with a mean age of 60.7 years. Histological examination showed follicular carcinoma in 15 cases, papillary carcinoma in 8, and medullary carcinoma in 1. Total en bloc spondylectomy was performed in 10 cases; debulking surgery, such as piecemeal excision or eggshell curettage, was performed in 14. The average follow-up time was 55 months (12–180 months). Results Four patients had no evidence of disease, 8 were alive with the disease, and 12 had died of the disease. The overall survival rate from the time of surgery was 74% at 5 years. Patients with visceral metastases had a significant, higher risk of death. The survival rate of patients following TES was 90% at 5 years, which was higher than the rate in patients who underwent debulking surgery (63%). However, no significant difference was observed between the 2 types of surgery. There was a local recurrence after debulking surgery in 8 (57%) of 14 cases. Because of the recurrences, reoperation was required after a mean of 41 months. In contrast, there was a local recurrence after TES in only 1 (10%) of 10 cases. The difference between debulking surgery and TES regarding local recurrence was statistically significant. Conclusions Total en bloc spondylectomy with enough of a margin provided favorable local control of spinal metastases of thyroid carcinoma during a patient's lifetime.

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

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.

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

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.

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

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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