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[Total en-bloc spondylectomy for recurrence spinal tumor]
Keng Chen1, Lin Huang1, Zhaopeng Cai1
1Department of Orthopedics, Research Center of Spinal and Pelvic Tumor, Sun Yat-sen Memorial Hospital, Research Institute for Spinal Cord Injury of Sun Yat-sen University, Research Center of Spinal and Spinal Cord Disease, Guangzhou 510120, China.
Objective:
To evaluate the clinical outcomes of total en-bloc spondylectomy (TES) in recurrence spinal tumor.
Methods:
The study was a retrospective study of recurrence spinal tumor from January 2010 to October 2013. A total of 6 patients with recurrent spinal tumor underwent TES procedures, with 5 cases located in thoracic spine and 1 case located in L1. There were 3 male and 3 female patients, with a mean age of 33.2 years. Pathological diagnosis included giant cell tumor of bone in 3 cases, breast cancer, lung cancer and nasopharyngeal carcinoma with 1 case in each. The operation time, bleeding loss, resected segments, cutting edge, spinal cord function and complications was evaluated.
Results:
Single segment resected in 1 case, 2 segments resected in 2 cases and 3 segments resected in 3 cases. The average operation time was 8.9 hours (7.5 to 12.0 hours). The average blood loss was 3 116 ml (2 500 to 4 500 ml). The average follow-up period was 23.2 months (12 to 47 months) without recurrence. There was no spinal cord injury during operation. The neurologic function was significantly improved in 2 cases (American Spinal Injury Association (ASIA) grade C to grade D), unchanged in 1 cases (ASIA grade B) and no deteriorated case in 3 cases (ASIA grade E). There was no perioperative deaths case. Complications included 2 cases pleural rupture, 1 case dural tear and 1 case massive haemothorax. No peri-operation death case.
Conclusion:
Some of the recurrent spinal tumors are still suitable for en-bloc resection and TES procedure with the extent of its applicability under strict control.