Major Complications and Sequelae After Total En Bloc Spondylectomy for Malignant Spinal Tumors. Issue 4 (November 2015)

• Record Type: Journal Article
• Authors: Matsumoto, Morio; Hikata, Tomohiro; Iwanami, Akio; Hosogane, Naobumi; Watanabe, Kota; Ishii, Ken; Nakamura, Masaya; Toyama, Yoshiaki
• Is Part Of: Neurosurgery quarterly. Volume 25:Issue 4(2015)
• Publication Date: 2015-11
• Subjects: total en bloc spondylectomy -- malignant -- spinal tumor -- complication; Nervous system -- Surgery -- Periodicals; 617.4805
• DOI: 10.1097/WNQ.0000000000000082
• Languages: English
• ISSNs: 1050-6438

Abstract

Abstract : This retrospective study looked at 33 consecutive patients with malignant, aggressive tumors in the thoracic and lumbar spine who underwent TES (24 men and 9 women; mean age 49.9 years; mean follow-up 3.6 years; 14 primary tumors and 19 metastatic tumors). TES was performed by a posterior-only approach in 15 patients and by a combined anterior and posterior approach in 18 patients. We classified complications as intraoperative, early (within 1 month after surgery), or late (>1 month after surgery), and examined the relationships between major complications and potentially related factors. Ten died of disease at 22.3 months after TES. Local recurrence was observed in 8 patients (24%) at an average of 15.4 months. Thirty-one major complications occurred in 24 patients (72.7%). There were 3 intraoperative, 17 early, and 11 late complications. Intraoperative complications included injury to the segmental artery, to the aorta, and to the spinal cord in 1 patient each. Early complications included prolonged chest tube drainage, cerebrospinal fluid leakage, and monoplegia due to the severing of nerve roots in 3 patients each, and pulmonary embolism, recurrent nerve palsy, pneumonia, endplate fracture, implant dislodgement, gastric ulcer, and ileus in 1 patient each. Late complications included implant failures in 8 patients and infection in 3 patients. Major complications were significantly associated with major blood loss ( P =0.047). TES was frequently associated with major intraoperative, early, and late postoperative complications; most complications were managed successfully.