title: Total En Bloc Spondylectomy for Primary and Metastatic Spine Tumors.
abstract: This study reports the surgical and clinical outcomes of spinal tumors managed with total en bloc spondylectomy. The authors searched their prospectively maintained database for patients undergoing total en bloc spondylectomy between 2001 and 2013. Ten patients (9 men, 1 woman; average age, 50.7 years; range, 42-68 years) were identified. The authors obtained demographic information, surgical outcomes (estimated blood loss, complications), and clinical outcomes (recurrence, survival). All patients had pain and were classified as American Spinal Injury Association grade E. The lesions were located in the thoracic (8 patients) and lumbar (2 patients) spine. Anterior column reconstruction was performed with strut allograft (7 patients), mesh cage (2 patients), and polymethyl methacrylate (1 patient). An average of 2.3 (range, 2-4) of 6 portions of the vertebrae were involved, according to the Kostuik classification. Mean estimated blood loss, operative time, and hospital stay were 3.5 L, 500 minutes, and 7.8 days, respectively. Perioperative complications included pleural tear (2 patients) and aortic tear, vena cava tear, retained sponge, pulmonary embolism, urinary tract infection, pneumothorax, anterior column support failure, and prominent instrumentation requiring removal (1 patient each). Postoperatively, all patients remained classified as American Spinal Injury Association grade E. Two patients had recurrence at distant spinal segments, and 1 had a new lesion in the thigh. Five patients had died (mean, 34.5 months after surgery), and 5 were alive a mean of 19.6 months after surgery (range, 6-48 months). Total en bloc spondylectomy is challenging, but in appropriately selected patients, it can be used to treat primary and metastatic spinal lesions.
authors.forename: Addisu
authors.initials: A
authors.lastname: Mesfin
authors.forename: Mostafa H
authors.initials: MH
authors.lastname: El Dafrawy
authors.forename: Amit
authors.initials: A
authors.lastname: Jain
authors.forename: Hamid
authors.initials: H
authors.lastname: Hassanzadeh
authors.forename: Khaled M
authors.initials: KM
authors.lastname: Kebaish
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D001843:Bone Cements; D016025:Bone Transplantation; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D019637:Orthopedic Procedures; D019904:Polymethyl Methacrylate; D019736:Prostheses and Implants; D013125:Spinal Neoplasms / Q000556:secondary / Q000601:surgery*; D013131:Spine / Q000601:surgery*
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate