STUDY DESIGN: Retrospective case series. OBJECTIVE: To evaluate the risk of infection, related treatment, and outcome after surgery of the 2 most common primary sacral tumors. SUMMARY OF BACKGROUND DATA: Rarity of sacral tumors has limited the number of population-based studies. Treatment depends on malignancy or local aggressiveness: wide resection is indicated for malignant lesions, intralesional surgery for benign. METHODS: We studied 82 patients with sacral chordomas (55 cases) or giant cell tumor (GCT) (27 cases) treated between 1976 and 2005. All patients had IV antibiotic therapy with amikacin and teicoplanin. Surgery of chordoma was resection; surgery of GCT was intralesional excision. Infections were classified as immediate postoperative, early (within 6 months), and late (more than 6 months from surgery). Mean follow-up was 9.5 years (range: 3-27 years). Some factors possibly influencing the risk of infection were statistically analyzed by Kaplan Meier curves and log-rank test. RESULTS: No deep infections were observed in the GCT series. Three patients with sacral chordoma died for postoperative complications and were excluded from this analysis. Of the remaining 52 patients with chordoma, 23/52 had deep wound infection (44%) that required 1 or more surgical debridements combined with antibiotics, according to cultures. In 16 patients (70%), infection occurred within 4 weeks postoperatively, and in 7 within 6 months. Most frequent bacteria were Enterococcus (23%), Escherichia coli (20%), and Pseudomonas aeruginosa (18%). In 74% of cases, infection was multimicrobial. Level of resection, previous intralesional treatment elsewhere, tumor volume, and age did not statistically influence risk of infection. CONCLUSION: Type of surgery was the prominent factor related to a major risk of infection. Operating procedure time correlated as well. Resections of sacral chordoma imply a high risk of deep infection, while intralesional excision of GCT does not. All infections healed with surgical debridements and antibiotic therapy.
STUDY DESIGN: Retrospective case series. OBJECTIVE: To evaluate the risk of infection, related treatment, and outcome after surgery of the 2 most common primary sacral tumors. SUMMARY OF BACKGROUND DATA: Rarity of sacral tumors has limited the number of population-based studies. Treatment depends on malignancy or local aggressiveness: wide resection is indicated for malignant lesions, intralesional surgery for benign. METHODS: We studied 82 patients with sacral chordomas (55 cases) or giant cell tumor (GCT) (27 cases) treated between 1976 and 2005. All patients had IV antibiotic therapy with amikacin and teicoplanin. Surgery of chordoma was resection; surgery of GCT was intralesional excision. Infections were classified as immediate postoperative, early (within 6 months), and late (more than 6 months from surgery). Mean follow-up was 9.5 years (range: 3-27 years). Some factors possibly influencing the risk of infection were statistically analyzed by Kaplan Meier curves and log-rank test. RESULTS: No deep infections were observed in the GCT series. Three patients with sacral chordoma died for postoperative complications and were excluded from this analysis. Of the remaining 52 patients with chordoma, 23/52 had deep wound infection (44%) that required 1 or more surgical debridements combined with antibiotics, according to cultures. In 16 patients (70%), infection occurred within 4 weeks postoperatively, and in 7 within 6 months. Most frequent bacteria were Enterococcus (23%), Escherichia coli (20%), and Pseudomonas aeruginosa (18%). In 74% of cases, infection was multimicrobial. Level of resection, previous intralesional treatment elsewhere, tumor volume, and age did not statistically influence risk of infection. CONCLUSION: Type of surgery was the prominent factor related to a major risk of infection. Operating procedure time correlated as well. Resections of sacral chordoma imply a high risk of deep infection, while intralesional excision of GCT does not. All infections healed with surgical debridements and antibiotic therapy.
Authors: Péter Pál Varga; Zsolt Szövérfi; Charles G Fisher; Stefano Boriani; Ziya L Gokaslan; Mark B Dekutoski; Dean Chou; Nasir A Quraishi; Jeremy J Reynolds; Alessandro Luzzati; Richard Williams; Michael G Fehlings; Niccole M Germscheid; Aron Lazary; Laurence D Rhines Journal: Eur Spine J Date: 2014-12-23 Impact factor: 3.134
Authors: Chetan Bettegowda; Stephen Yip; Sheng-Fu Larry Lo; Charles G Fisher; Stefano Boriani; Laurence D Rhines; Joanna Y Wang; Aron Lazary; Marco Gambarotti; Wei-Lien Wang; Alessandro Luzzati; Mark B Dekutoski; Mark H Bilsky; Dean Chou; Michael G Fehlings; Edward F McCarthy; Nasir A Quraishi; Jeremy J Reynolds; Daniel M Sciubba; Richard P Williams; Jean-Paul Wolinsky; Patricia L Zadnik; Ming Zhang; Niccole M Germscheid; Vasiliki Kalampoki; Peter Pal Varga; Ziya L Gokaslan Journal: Neuro Oncol Date: 2017-03-01 Impact factor: 12.300
Authors: Hyun Ok Ham; Sung Hyun Park; Josh W Kurutz; Igal G Szleifer; Phillip B Messersmith Journal: J Am Chem Soc Date: 2013-08-21 Impact factor: 15.419
Authors: Laura M Vos; Philippe C Morand; David Biau; Denis Archambeau; Luc-Jean Eyrolle; Julien Loubinoux; Valerie Perut; Philippe Leclerc; Joop E Arends; Philippe Anract; Dominique Salmon Journal: Infect Dis Ther Date: 2015-09-03
Authors: Scott L Zuckerman; Sun-Ho Lee; George J Chang; Garrett L Walsh; Reza J Mehran; Ziya L Gokaslan; Ganesh Rao; Claudio E Tatsui; Laurence D Rhines Journal: Global Spine J Date: 2021-06