title: Corpectomy and Vertebral Body Reconstruction with Expandable Cage Placement and Osteosynthesis via the single stage Posterior Approach: a Retrospective Series of 34 Patients with Thoracic and Lumbar Spine Vertebral Body Tumors.
abstract: BACKGROUND
  Metastatic disease of the spine requires a multidisciplinary and comprehensive approach to patient care, especially, for patients in a lot of pain with neurological deficit or spinal instability requiring surgical stabilization.
  
  
  OBJECTIVE
  The purpose of the study is to report our experience on 34 patients who underwent spinal metastasis resection. We used a single-stage posterior approach with vertebral body reconstruction by an expandable titanium cage and a posterior instrumentation. The parameters assessed were neurologic status, OMS score, angle of sagittal deformity, and morbidity.
  
  
  METHODS
  Between January 2011 and June 2014 we performed a monocentric consecutive case review of 34 patients with vertebral body tumor. All of them underwent a single-stage vertebrectomy with circumferential reconstruction and an arthrodesis by posterior approach.
  
  
  RESULTS
  34 patients underwent a single stage surgery by posterior approach, including 30 thoracic lesions and 4 lumbar lesions. Pre operatively, sixteen patients presented a neurologic impairment. The mean follow-up was 13.7 months [1-32 m]. No neurologic impairment was observed in the 34 cases. At the last term of follow-up, neurologic status was improved in 23 cases. OMS score was improved in 23 cases (67.6 %), and worsened in one case. Before surgery, the average of visual analogic scale was 8.94/10 [7-10] and decreased to 2.62/10 [1-5] after surgery. Single posterior approach surgery significantly reduced the average sagittal deformity to 10.0° (0.01-19.96; P = 0.013, Mann-Whitney test).
  
  
  CONCLUSIONS
  Our outcomes suggest that it will be more efficient to perform an aggressive approach in spinal metastatic treatment in order to improve quality of life.
authors.affiliation: Department of Spine Surgery, Aix-Marseille University, Marseille, France; Department of Neurosurgery, Timone University Hospital, Marseille, France. Electronic address: christophe.joubert@neurochirurgie.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Joubert
authors.affiliation: Department of Spine Surgery, Aix-Marseille University, Marseille, France; Department of Neurosurgery, Timone University Hospital, Marseille, France.
authors.forename: Tarek
authors.initials: T
authors.lastname: Adetchessi
authors.affiliation: Department of Spine Surgery, Aix-Marseille University, Marseille, France; Department of Orthopedic Surgery, Timone University Hospital, Marseille, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Peltier
authors.affiliation: Department of Spine Surgery, Aix-Marseille University, Marseille, France; Department of Neurosurgery, Timone University Hospital, Marseille, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Graillon
authors.affiliation: Department of Spine Surgery, Aix-Marseille University, Marseille, France; Department of Neurosurgery, Timone University Hospital, Marseille, France.
authors.forename: Henry
authors.initials: H
authors.lastname: Dufour
authors.affiliation: Department of Spine Surgery, Aix-Marseille University, Marseille, France; Department of Orthopedic Surgery, Timone University Hospital, Marseille, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Blondel
authors.affiliation: Department of Spine Surgery, Aix-Marseille University, Marseille, France; Department of Neurosurgery, Timone University Hospital, Marseille, France.
authors.forename: Stephane
authors.initials: S
authors.lastname: Fuentes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery*; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium
keywords: Corpectomy; Expandable cage; OMS status; Single stage posterior approach; Spinal metastasis