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Neurological function after total en bloc spondylectomy for thoracic spinal tumors
Hideki Murakami1, Norio Kawahara, Satoru Demura
1Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan. hmuraka@med.kanazawa-u.ac.jp
Journal of Neurosurgery. Spine
|March 3, 2010
Summary
Total en bloc spondylectomy (TES) for thoracic spinal tumors is a safe procedure. This study found no neurological deterioration, with many patients experiencing improved neurological function after surgery.
Area of Science:
- Neurosurgery
- Spinal Oncology
- Oncologic Surgery
Background:
- Thoracic total en bloc spondylectomy (TES) carries theoretical risks of neurological compromise.
- Potential insults include embolization, arterial ligation, nerve root ligation, and dural dissection.
Purpose of the Study:
- To assess neurological function and outcomes following thoracic TES for spinal tumors.
Main Methods:
- Retrospective review of 79 patients undergoing thoracic TES (1989-2006).
- Neurological function assessed using the Frankel grading system.
- Analysis included tumor type (primary vs. metastatic) and extent of vertebral resection.
Main Results:
- No cases of neurological deterioration were observed post-operatively.
- Of 46 patients with pre-operative deficits, 54.3% showed at least a one-grade improvement.
- All patients with pre-operative deficits experienced some neurological symptom improvement.
Conclusions:
- Thoracic TES is a safe procedure regarding spinal cord blood flow.
- Circumferential decompression and spinal shortening may enhance spinal cord blood flow.
- TES can lead to resolution of neurological symptoms in patients with thoracic spinal tumors.