title: Influence of a thread wire saw guide and spinal cord protector device in "en bloc" vertebrectomies.
abstract: METHODS
  Retrospective cohort study.
  
  
  OBJECTIVE
  The objective of the study was to describe and compare the surgical outcomes between the use of a new auto static spinal cord and thread wire guiding device and the traditional scalpel technique for en bloc vertebrectomies using only the posterior approach.
  
  
  BACKGROUND
  As en bloc vertebrectomy has become more accepted as the ideal treatment for selected cases of spine tumors, its high morbidity has to be kept in mind. Uneven cutting surfaces and high risk of spinal cord lesions are among the problems. Although some modifications of the technique and development of new devices to minimize the risks have been reported, there are still some pitfalls associated with them.
  
  
  METHODS
  Twenty-five patients, divided into 2 groups, were retrospectively reviewed. Patients in group 1 (G1) were operated using the device, and the patients in group 2 (G2) underwent en bloc vertebrectomy by the traditional scalpel technique. The surgical time, amount of blood loss based on the total volume of blood transfusion during surgery, and the rate of complication were compared.
  
  
  RESULTS
  No differences regarding sex, age, and preoperative status occurred. The mean operative time was 294 and 388 minutes and the mean volume of transfused blood was 37 and 53 mL/kg for G1 and G2, respectively. These differences were not statistically significant.
  
  
  CONCLUSIONS
  Patient selection and surgical experience are the best outcome predictors. However, methods to reduce the risks of neural lesions, surgical time, and blood loss should always be applied, specially dealing with highly morbid and demanding procedures in the spine.
authors: Department of Oncologic and Degenerative Spine Surgery, Rizzoli Institute, Bologna, Italy.
authors: Alessandro
authors: A
authors: Gasbarrini
authors: Christiano Esteves
authors: CE
authors: Simoes
authors: Luca
authors: L
authors: Amendola
authors: Stefano
authors: S
authors: Bandiera
authors: Giovanni Barbanti
authors: GB
authors: Bròdano
authors: Michele
authors: M
authors: Cappuccio
authors: Stefano
authors: S
authors: Boriani
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000473:pathology / Q000601:surgery*; D013131:Spine / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome