Revision surgery for instrumentation failure after total en bloc spondylectomy: a retrospective case series
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(2020) 21:591
RESEARCH ARTICLE
Open Access
Revision surgery for instrumentation failure after total en bloc spondylectomy: a retrospective case series Kazuya Shinmura1, Satoshi Kato1, Satoru Demura1*, Noriaki Yokogawa1, Noritaka Yonezawa1, Takaki Shimizu1, Norihiro Oku1, Ryo Kitagawa1, Makoto Handa1, Ryohei Annen1, Hideki Murakami2 and Hiroyuki Tsuchiya1
Abstract Background: There have been several reports of instrumentation failure after three-column resections such as total en bloc spondylectomy (TES) for spinal tumors; however, clinical outcomes of revision surgery for instrumentation failure after TES are seldom reported. Therefore, this study assessed the clinical outcomes of revision surgery for instrumentation failure after TES. Methods: This study employed a retrospective case series in a single center and included 61 patients with spinal tumors who underwent TES between 2010 and 2015 and were followed up for > 2 years. Instrumentation failure rate, back pain, neurological deterioration, ambulatory status, operation time, blood loss, complications, bone fusion after revision surgery, and re-instrumentation failure were assessed. Data were collected on back pain, neurological deterioration, ambulatory status, and management for patients with instrumentation failure, and we documented radiological bone fusion and re-instrumentation failure in cases followed up for > 2 years after revision surgery. Results: Of the 61 patients, 26 (42.6%) experienced instrumentation failure at an average of 32 (range, 11–92) months after TES. Of these, 23 underwent revision surgery. The average operation time and intraoperative blood loss were 204 min and 97 ml, respectively. Including the six patients who were unable to walk after instrumentation failure, all patients were able to walk after revision surgery. Perioperative complications of reoperation were surgical site infection (n = 2) and delayed wound healing (n = 1). At the final follow-up, bone fusion was observed in all patients. No re-instrumentation failure was recorded. Conclusion: Bone fusion was achieved by revision surgery using the posterior approach alone. Keywords: Total en bloc spondylectomy, Instrumentation failure, Revision surgery, Cobalt chromium, Bone fusion, Liquid nitrogen
* Correspondence: [email protected] 1 Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-0961, Japan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to th
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