Thoracolumbar corpectomy/spondylectomy for spinal metastasis: a pooled analysis comparing the outcome of seven different surgical approaches.
Eur Spine J
; 29(2): 248-256, 2020 02.
Article
en En
| MEDLINE
| ID: mdl-31641907
ABSTRACT
OBJECTIVE:
To compare surgical outcomes between seven different approaches for thoracolumbar corpectomy/spondylectomy in the setting of spinal metastasis.METHODS:
A systematic review of literature was performed including articles on corpectomy for thoracolumbar spinal metastasis. Data were extracted and sorted by surgicalapproach:
en bloc spondylectomy (group 1), transpedicular (group 2), costotransversectomy (group 3), mini-open retropleural/retroperitoneal (group 4a), lateral extracavitary approach (group 4b), open transthoracic/transretroperitoneal (group 5), and thoracoscopic (group 6). Comparison of demographics, blood loss, directly procedure related complications, operating time, and postoperative improvement of pain.RESULTS:
A total of 63 articles were included comprising data of 774 patients with various primary tumor entities. Mean age was 51.8 years, 54% of patients were female, on average 1.46 levels were treated per patient, and mean follow-up was 1.59 years. The following statistically significant findings were observed Blood loss was lowest for the mini-open retropleural/retroperitoneal (917 ml), thoracoscopic (1107 ml) and transthoracic approach (1172 ml) versus the posterior approach groups (1633-2261 ml); directly procedure related complications were lowest for mini-open retropleural/retroperitoneal and thoracoscopic approach (0% each) versus 7-15% in the other groups; operating time was lowest in mini-open retropleural/retroperitoneal approach (184 min) versus 300-588 min in the other groups.CONCLUSION:
Less invasive approaches (mini-open retropleural/retroperitoneal and thoracoscopic) not only had superior outcome in terms of blood loss and operating time, but also were shown to be safe techniques in cancer patients with low rates of procedure-related complications. These slides can be retrieved under Electronic Supplementary Material.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias de la Columna Vertebral
/
Procedimientos Ortopédicos
Tipo de estudio:
Systematic_reviews
Límite:
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Eur Spine J
Asunto de la revista:
ORTOPEDIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Estados Unidos