Total en bloc spondylectomy combined with the satellite rod technique for spinal tumors
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(2020) 15:536
RESEARCH ARTICLE
Open Access
Total en bloc spondylectomy combined with the satellite rod technique for spinal tumors Hongyu Wei1*† , Chunke Dong1,2†, Jun Wu3, Yuting Zhu4 and Haoning Ma1
Abstract Background: Instrumentation failure (IF) is a common complication after total en bloc spondylectomy (TES) in spinal tumors. This study aims to evaluate the clinical outcomes of TES combined with the satellite rod technique for the treatment of primary and metastatic spinal tumors. Methods: The clinical data of 15 consecutively treated patients with spinal tumors who underwent TES combined with the satellite rod technique by a single posterior approach from June 2015 to September 2018 were analyzed retrospectively. Radiographic parameters including the local kyphotic angle (LKA), anterior vertebral height (AVH), posterior vertebral height (PVH), and intervertebral titanium mesh cage height (ITMCH) were assessed preoperatively, postoperatively, and at the final follow-up. The visual analog scale (VAS), Oswestry Disability Index (ODI), and American Spinal Injury Association (ASIA) scale were used to assess quality of life and neurological function. The operative duration, volume of blood loss, and complications were also recorded. Results: The mean operation time and volume of blood loss were 361.7 min and 2816.7 mL, respectively. During an average follow-up of 31.1 months, 2 patients died of tumor recurrence and multiple organ metastases, while recurrence was not found in any other patients. Solid fusion was achieved in all but one patient, and no implant-related complications occurred during the follow-up. The VAS, ODI, and ASIA scores significantly improved from before to after surgery (P < 0.05). The LKA, AVH, and PVH significantly improved from before to immediately after surgery and to the final follow-up (P < 0.05), and the postoperative and final follow-up values did not significantly differ (P > 0.05). Conclusions: TES combined with the satellite rod technique can yield strong three-dimensional fixation and reduce the occurrence of rod breakage, thereby improving the long-term quality of life of patients with spinal tumors. Keywords: Total en bloc spondylectomy, Satellite rod, Spine, Primary tumor, Neoplasm metastasis
Background Currently, it is generally accepted that total en bloc spondylectomy (TES), in combination with multidisciplinary management, is crucial for disease-free survival in patients with primary and metastatic spinal neoplasms [1–3]. TES, * Correspondence: [email protected] † Hongyu Wei and Chunke Dong contributed equally to this study and should be considered co-first authors. 1 Department of Orthopaedic Surgery, China-Japan Friendship Hospital, 2 Yinghuadong Road, Chaoyang District, Beijing 100029, China Full list of author information is available at the end of the article
which was first described by Tomita et al. [4] in 1994, has been proven to decrease the rate of local recurrence and prolong survival via a margin-free resection which can prevent tumor cell contamination i
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