Yoshiomi Kobayashi1,2, Soya Kawabata2,3, Yuichiro Nishiyama2,4, Osahiko Tsuji1,2, Eijiro Okada1,2, Nobuyuki Fujita1,2, Mitsuru Yagi1,2, Kota Watanabe1,2, Morio Matsumoto1,2, Masaya Nakamura1,2, Narihito Nagoshi5,6. 1. Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan. 2. Keio Spine Research Group (KSRG), Tokyo, Japan. 3. Department of Orthopaedic Surgery, Keiyu Hospital, Kanagawa, Yokohama, Japan. 4. Department of Orthopaedic Surgery, Saitama City Hospital, Saitama, Japan. 5. Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan. nagoshi@2002.jukuin.keio.ac.jp. 6. Keio Spine Research Group (KSRG), Tokyo, Japan. nagoshi@2002.jukuin.keio.ac.jp.
Abstract
STUDY DESIGN: Retrospective chart audit. OBJECTIVES: This study investigated changes in sagittal alignment in adults after excision of thoracic spinal cord tumors without spinal fixation. SETTING: Single-center study at an academic orthopedic department in Japan. METHODS: We retrospectively reviewed records for 32 adults who underwent excision of thoracic spinal cord tumors by multilevel laminectomies without fixation. The participants were divided according to whether the tumor was in the upper (T1-4), middle (T5-8), or lower (T9-12) thoracic spine. We analyzed parameters such as age, sex, time in surgery and estimated blood loss, follow-up period, and preoperative and follow-up the Japanese Orthopaedic Association (JOA) scores and radiographs. RESULTS: Postoperative T1-12 kyphotic changes did not correlate with age, the number of resected laminae, or preoperative T1-12 kyphosis. JOA recovery rates were similar regardless of the tumor location. Participants with tumors in the upper thoracic spine had significant postoperative increases in T1-4 kyphosis, T1 slope (p < .05, respectively). In contrast, there were no significant changes in alignment in participants with tumors in the middle or lower thoracic spine. CONCLUSION: Even without fixation, sagittal alignment did not change after surgery to excise tumors in the middle and lower thoracic spine, indicating that fixation may not be necessary when excising spinal cord tumors in this region. In contrast, postoperative kyphosis may increase when the tumor is in the upper thoracic spine.
STUDY DESIGN: Retrospective chart audit. OBJECTIVES: This study investigated changes in sagittal alignment in adults after excision of thoracic spinal cord tumors without spinal fixation. SETTING: Single-center study at an academic orthopedic department in Japan. METHODS: We retrospectively reviewed records for 32 adults who underwent excision of thoracic spinal cord tumors by multilevel laminectomies without fixation. The participants were divided according to whether the tumor was in the upper (T1-4), middle (T5-8), or lower (T9-12) thoracic spine. We analyzed parameters such as age, sex, time in surgery and estimated blood loss, follow-up period, and preoperative and follow-up the Japanese Orthopaedic Association (JOA) scores and radiographs. RESULTS: Postoperative T1-12 kyphotic changes did not correlate with age, the number of resected laminae, or preoperative T1-12 kyphosis. JOA recovery rates were similar regardless of the tumor location. Participants with tumors in the upper thoracic spine had significant postoperative increases in T1-4kyphosis, T1 slope (p < .05, respectively). In contrast, there were no significant changes in alignment in participants with tumors in the middle or lower thoracic spine. CONCLUSION: Even without fixation, sagittal alignment did not change after surgery to excise tumors in the middle and lower thoracic spine, indicating that fixation may not be necessary when excising spinal cord tumors in this region. In contrast, postoperative kyphosis may increase when the tumor is in the upper thoracic spine.
Authors: P J Papagelopoulos; H A Peterson; M J Ebersold; P R Emmanuel; S N Choudhury; L M Quast Journal: Spine (Phila Pa 1976) Date: 1997-02-15 Impact factor: 3.468
Authors: Kevin C Yao; Matthew J McGirt; Kaisorn L Chaichana; Shlomi Constantini; George I Jallo Journal: J Neurosurg Date: 2007-12 Impact factor: 5.115