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Basic concepts in metal work failure after metastatic spine tumour surgery
Naresh Kumar1,2, Ravish Patel3, Anshuja Charvi Wadhwa4
1Department of Orthopaedic Surgery, National University Hospital, Singapore, 119074, Singapore. dosksn@nus.edu.sg.
Summary
Spinal implant failures occur in 2-8% of metastatic spine tumor surgeries (MSTS). Understanding failure modes and a new classification can help prevent complications.
Area of Science:
- Spinal surgery
- Oncology
- Biomedical engineering
Background:
- Metastatic spine tumor surgery (MSTS) has evolved with spinal implants.
- Increased patient survival raises concerns about implant failure rates.
Purpose of the Study:
- To review implants/constructs in MSTS.
- To highlight biomechanics of implant/construct failures.
- To establish a clear understanding of implant failures in MSTS.
Main Methods:
- Literature review on implant failure after spine surgery and MSTS.
- Description of spinal implant evolution in MSTS.
- Definition of implant/construct failures using radiological parameters.
- Discussion of common failure modes.
Main Results:
- Implant failure rates in MSTS range from 2-8%.
- Failure patterns vary by anatomical region and construct type.
- Failures can be early or late, symptomatic or asymptomatic.
- Not all implant failures necessitate revision surgery.
Conclusions:
- A clinico-radiological classification for implant/construct failure after MSTS has been proposed.
- This classification is based on observed radiological criteria and clinical presentations.
