A Thomas1, T Hollstein2, S Zwingenberger2, K-D Schaser2, A C Disch2. 1. Universitätswirbelsäulenzentrum (UCSC), UniversitätsCentrum für Orthopädie und Unfallchirurgie (OUC), Universitätsklinikum Carl Gustav Carus Dresden, TU Dresden, Anstalt des öffentlichen Rechts des Freistaates Sachsen, Fetscherstraße 74, 01307, Dresden, Deutschland. Alexander.Thomas@uniklinikum-dresden.de. 2. Universitätswirbelsäulenzentrum (UCSC), UniversitätsCentrum für Orthopädie und Unfallchirurgie (OUC), Universitätsklinikum Carl Gustav Carus Dresden, TU Dresden, Anstalt des öffentlichen Rechts des Freistaates Sachsen, Fetscherstraße 74, 01307, Dresden, Deutschland.
Abstract
BACKGROUND: Spinal tumors are a continuously growing pathology group among the spinal diseases. The often-difficult circumstances increase vulnerability to a wide range of intervention-related complications, which can occur at different times in the course of the disease and must be included in the consideration of the indication. OBJECTIVES: The aim of the work is to present the wide spectrum of complications in the surgical treatment of spinal tumors, as well as their treatment and prophylaxis through optimal therapy management. MATERIALS AND METHODS: The article summarizes the current literature. RESULTS: The literature describes complication rates of 10-67% after metastatic surgery of the spinal column. The most common complications are infections and internal, especially pulmonary, complications. Other relevant complications include surgical positioning/surgical access/instrumentation/mechanical failure, and anesthesiological, neurological, vascular and oncological complications. The socio-economic costs for patients with complications compared to those for patients without complications are twice as high. A special risk situation exists with radical spinal tumor resections. Negative predictors are previous operations, previous irradiation and local recurrences. CONCLUSIONS: An early, interdisciplinary concept can reduce complications significantly. Due to the planning intensity, surgical expertise and comprehensive structural requirements, treatment in an interdisciplinary tumour centre is necessary.
BACKGROUND:Spinal tumors are a continuously growing pathology group among the spinal diseases. The often-difficult circumstances increase vulnerability to a wide range of intervention-related complications, which can occur at different times in the course of the disease and must be included in the consideration of the indication. OBJECTIVES: The aim of the work is to present the wide spectrum of complications in the surgical treatment of spinal tumors, as well as their treatment and prophylaxis through optimal therapy management. MATERIALS AND METHODS: The article summarizes the current literature. RESULTS: The literature describes complication rates of 10-67% after metastatic surgery of the spinal column. The most common complications are infections and internal, especially pulmonary, complications. Other relevant complications include surgical positioning/surgical access/instrumentation/mechanical failure, and anesthesiological, neurological, vascular and oncological complications. The socio-economic costs for patients with complications compared to those for patients without complications are twice as high. A special risk situation exists with radical spinal tumor resections. Negative predictors are previous operations, previous irradiation and local recurrences. CONCLUSIONS: An early, interdisciplinary concept can reduce complications significantly. Due to the planning intensity, surgical expertise and comprehensive structural requirements, treatment in an interdisciplinary tumour centre is necessary.
Entities:
Keywords:
Infection; Local neoplasm recurrence; Neurosurgical procedures; Spinal neoplasms; Vertebra
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