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Surgical outcomes and risk factors for surgical complications after en bloc resection following reconstruction with 3D-printed artificial vertebral body for thoracolumbar tumors.
Hu, Jinxin; Song, Guohui; Chen, Hongmin; Xu, Huaiyuan; Wang, Anqi; Wang, Xiangqin; Hou, Bingbing; Lu, Jinchang; Tang, Qinglian; Wang, Jin; Zhu, Xiaojun.
Afiliação
  • Hu J; Department of Musculoskeletal Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
  • Song G; State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
  • Chen H; Department of Musculoskeletal Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
  • Xu H; State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
  • Wang A; Department of Musculoskeletal Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
  • Wang X; State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
  • Hou B; Department of Musculoskeletal Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
  • Lu J; State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
  • Tang Q; Department of Musculoskeletal Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
  • Wang J; State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
  • Zhu X; Department of Musculoskeletal Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
World J Surg Oncol ; 21(1): 385, 2023 Dec 14.
Article em En | MEDLINE | ID: mdl-38097982
ABSTRACT

BACKGROUND:

The outcomes of patients with tumors of the thoracolumbar spine treated with en bloc resection (EBR) using three-dimensional (3D)-printed endoprostheses are underreported.

METHODS:

We retrospectively evaluated patients with thoracolumbar tumors who underwent surgery at our institution. Logistic regression analysis was performed to identify the potential risk factors for surgical complications. Nomograms to predict complications were constructed and validated.

RESULTS:

A total of 53 patients with spinal tumors underwent EBR at our hospital; of these, 2 were lost to follow-up, 45 underwent total en bloc spondylectomy, and 6 were treated with sagittal en bloc spondylectomy. The anterior reconstruction materials included a customized 3D-printed artificial vertebral body (AVB) in 10 cases and an off-the-shelf 3D-printed AVB in 41 cases, and prosthesis mismatch occurred in 2 patients reconstructed with the off-the-shelf 3D-printed AVB. The median follow-up period was 21 months (range, 7-57 months). Three patients experienced local recurrence, and 5 patients died at the final follow-up. A total of 50 perioperative complications were encountered in 29 patients, including 25 major and 25 minor complications. Instrumentation failure occurred in 1 patient, and no prosthesis subsidence was observed. Using a combined surgical approach was a dependent predictor of overall complications, while Karnofsky performance status score, lumbar spine lesion, and intraoperative blood loss ≥ 2000 mL were predictors of major complications. Nomograms for the overall and major complications were constructed using these factors, with C-indices of 0.850 and 0.891, respectively.

CONCLUSIONS:

EBR is essential for the management of thoracolumbar tumors; however, EBR has a steep learning curve and a high complication rate. A 3D-printed AVB is an effective and feasible reconstruction option for patients treated with EBR.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Coluna Vertebral / Corpo Vertebral Limite: Humans Idioma: En Revista: World J Surg Oncol Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Coluna Vertebral / Corpo Vertebral Limite: Humans Idioma: En Revista: World J Surg Oncol Ano de publicação: 2023 Tipo de documento: Article