Rong Ping Zhou1, Praveen V Mummaneni2, Kai-Yuan Chen3, Darryl Lau2, Kai Cao4, Dominic Amara2, Can Zhang5, Sanjay Dhall2, Dean Chou2. 1. Department of Orthopedics, The Second Affiliated Hospital of Nan Chang University, Nan Chang, China; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA. Electronic address: rongg106@163.com. 2. Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA. 3. Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA; Department of Neurosurgery, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Surgery, Taichung Veterans General Hospital Puli Branch, Nantou, Taiwan. 4. Department of Orthopedics, The Second Affiliated Hospital of Nan Chang University, Nan Chang, China. 5. Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA; Department of Neurological Surgery, Xuan Wu Hospital of Capital Medical University, Beijing, China.
Abstract
OBJECTIVE: To retrospectively analyze the outcomes and complications of patients with metastatic thoracic spinal tumors (MTTs) who underwent posterior corpectomies. METHODS: Ninety patients with MTTs who underwent posterior corpectomies were retrospectively analyzed. Characteristics evaluated included number of MTTs per year, location, involved vertebrae numbers, sex, histology, pre- and postoperative American Spinal Injury Association (ASIA) grade, visual analog scale (VAS) pain scores, operative time, blood loss, and length of hospital stay. RESULTS: The average follow-up was 20.8 ± 27.9 months (range, 0.5-139.4 months). Of the patients, 76.67% had a single metastasis and 23.33% had multiple metastases. For histology, 16.67% were breast, 15.56% were lung, 12.22% were prostate, and 12.22% were renal cell carcinoma. Of the patients with paraplegia and paraparesis, 74% improved. One patient improved from ASIA grade A to D, 3 patients improved from grade B to C, 8 patients improved from grade C to D or E, and 25 patients improved from grade D to E. Three patients (6%) with ASIA grade A and 1 patient (2%) with ASIA grade B had no improvement. One patient with ASIA grade C and 8 patients (16%) with grade D had no improvement. After surgery, VAS pain scores decreased from 8.45 ± 1.57 to 1.211 ± 1.81. In terms of complications, 2 patients (2.22%) had deep vein thrombosis and 1 patient had pulmonary embolism (1.11%). Other complications included wound infection (4.44%), cerebrospinal fluid leak (4.44%), pleural effusion (3.33%), wound dehiscence (2.22%), cellulitis (1.11%), epidural hematoma (1.11%), and pneumothorax (1.11%). Of the patients, 2.22% had implant failure and pseudoarthrosis, with 1 patient needing revision surgery. One patient (1.11%) had tumor recurrence. CONCLUSIONS: Our results suggest that posterior thoracic corpectomies for MTTs have a reasonable complication rate with favorable outcomes.
OBJECTIVE: To retrospectively analyze the outcomes and complications of patients with metastatic thoracic spinal tumors (MTTs) who underwent posterior corpectomies. METHODS: Ninety patients with MTTs who underwent posterior corpectomies were retrospectively analyzed. Characteristics evaluated included number of MTTs per year, location, involved vertebrae numbers, sex, histology, pre- and postoperative American Spinal Injury Association (ASIA) grade, visual analog scale (VAS) pain scores, operative time, blood loss, and length of hospital stay. RESULTS: The average follow-up was 20.8 ± 27.9 months (range, 0.5-139.4 months). Of the patients, 76.67% had a single metastasis and 23.33% had multiple metastases. For histology, 16.67% were breast, 15.56% were lung, 12.22% were prostate, and 12.22% were renal cell carcinoma. Of the patients with paraplegia and paraparesis, 74% improved. One patient improved from ASIA grade A to D, 3 patients improved from grade B to C, 8 patients improved from grade C to D or E, and 25 patients improved from grade D to E. Three patients (6%) with ASIA grade A and 1 patient (2%) with ASIA grade B had no improvement. One patient with ASIA grade C and 8 patients (16%) with grade D had no improvement. After surgery, VAS pain scores decreased from 8.45 ± 1.57 to 1.211 ± 1.81. In terms of complications, 2 patients (2.22%) had deep vein thrombosis and 1 patient had pulmonary embolism (1.11%). Other complications included wound infection (4.44%), cerebrospinal fluid leak (4.44%), pleural effusion (3.33%), wound dehiscence (2.22%), cellulitis (1.11%), epidural hematoma (1.11%), and pneumothorax (1.11%). Of the patients, 2.22% had implant failure and pseudoarthrosis, with 1 patient needing revision surgery. One patient (1.11%) had tumor recurrence. CONCLUSIONS: Our results suggest that posterior thoracic corpectomies for MTTs have a reasonable complication rate with favorable outcomes.
Authors: Fabio Cofano; Giuseppe Di Perna; Nicola Marengo; Marco Ajello; Antonio Melcarne; Francesco Zenga; Diego Garbossa Journal: Neurosurg Rev Date: 2019-11-12 Impact factor: 3.042