title: Health-Related Quality of Life After Spine Surgery for Primary Bone Tumour.
abstract: Treatment of primary bone tumours (PBT) of the spine is complex, often involving numerous surgical and oncology disciplines. Surgical en bloc resection with oncologically appropriate margins is the modality of choice when treating malignant PBT. En bloc resection with wide or marginal margins appears to offer better local and systemic control of the disease. This type of surgical resection can also be considered when treating benign aggressive tumours such as aneurysmal bone cyst, giant cell tumour and osteoblastoma. Although these surgeries respect oncologic principles, significant morbidity and mortality are associated. Adverse event collection is highly variable in the literature and mostly from retrospective studies. Wound complication, neurologic deficit and significant blood loss are encountered with surgical resection of PBT of the mobile spine and especially, the sacrum. The adverse event profile of these surgeries is high even in experienced quaternary referral centres. Therefore, primary spinal tumour resection is best performed in experienced centre with adequate multidisciplinary support. Furthermore, prospective and systematic adverse event data collection should be developed to ensure accurate data. The impact of such extensive and potentially impairment producing procedures on health-related quality of life (HRQOL) is another critically valuable piece of information in the era of shared treatment decision making. At the present time, there is paucity of published data regarding HRQOL following these surgeries. Nonetheless, in theory, it seems that health-related quality of life after surgery for PBT is acceptable given the curative intent of the treatment. However, a decision-making process should be tailored to each patient and his or her expectations. Comprehensive discussions should be held preoperatively with the patient, family and other related allied health professionals if the informed consent and decision-making process is to be optimal.
authors.affiliation: Department of Orthopaedics, Centre Hospitalier Universitaire de Québec, 1401 18e rue, Local B-2408, Quebec, Quebec, Canada, G1J 1Z4. Raphaele.charest-morin.1@ulaval.ca.
authors.forename: Raphaële
authors.initials: R
authors.lastname: Charest-Morin
authors.affiliation: Division of Neurosurgery, Department of Surgery, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12th Avenue North, Local 5110, Sherbrooke, QC, Canada, J1H 5 N4. Nicolas.dea@usherbrooke.ca.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Dea
authors.affiliation: Division of Spine, Department of Orthopaedics, The Combined Neurosurgical and Orthopaedic Spine Program at Vancouver Coastal Health, Blusson Spinal Cord Centre, 6th Floor, 818 West 10th Avenue, Vancouver, BC, Canada, V5Z 1M9. Charles.fisher@vch.ca.
authors.forename: Charles G
authors.initials: CG
authors.lastname: Fisher
mesh_terms: D006801:Humans; D011788:Quality of Life; D020127:Recovery of Function; D013125:Spinal Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Adverse event; Complications; En bloc resection; Functional outcomes; Mobile spine; Morbidity; Mortality; Primary bone tumour; Quality of life; Sacrectomy; Sacrum; Spine
references.citation: Eur Spine J. 2013 Jun;22(6):1375-82
references.pmid: 23263168
references.citation: Spine (Phila Pa 1976). 2012 Mar 15;37(6):E381-6
references.pmid: 22422440
references.citation: Spine (Phila Pa 1976). 2010 Jun 15;35(14):1377-86
references.pmid: 20505561
references.citation: Chir Organi Mov. 1997 Oct-Dec;82(4):357-72
references.pmid: 9618974
references.citation: Spine (Phila Pa 1976). 2011 Sep 1;36(19):1570-8
references.pmid: 21245786
references.citation: J Neurosurg Spine. 2014 Nov;21(5):698-703
references.pmid: 25147976
references.citation: Spine (Phila Pa 1976). 2006 Feb 15;31(4):493-503
references.pmid: 16481964
references.citation: Eur Spine J. 2008 Apr;17(4):600-9
references.pmid: 18214553
references.citation: Spine (Phila Pa 1976). 2011 Nov 15;36(24):E1581-7
references.pmid: 22048652
references.citation: J Neurosurg Spine. 2014 Sep;21(3):348-56
references.pmid: 24926926
references.citation: Spine (Phila Pa 1976). 2009 Oct 15;34(22 Suppl):S48-57
references.pmid: 19829277
references.citation: Clin Orthop Relat Res. 1980 Nov-Dec;(153):106-20
references.pmid: 7449206
references.citation: Am J Clin Oncol. 1982 Dec;5(6):649-55
references.pmid: 7165009
references.citation: Eur Spine J. 2007 Mar;16(3):405-9
references.pmid: 16865376
references.citation: Neurosurg Focus. 2003 Nov 15;15(5):E9
references.pmid: 15323466
references.citation: J Neurosurg Spine. 2005 Feb;2(2):199-205
references.pmid: 15739534
references.citation: J Bone Joint Surg Am. 1980 Sep;62(6):1027-30
references.pmid: 7000786
references.citation: Paraplegia. 1994 Jun;32(6):396-406
references.pmid: 8090548
references.citation: Eur Spine J. 2010 Feb;19(2):231-41
references.pmid: 19690899
references.citation: Eur Spine J. 2013 Sep;22(9):2069-76
references.pmid: 23588996
references.citation: J Neurosurg Spine. 2011 Feb;14(2):143-50
references.pmid: 21184634
references.citation: Eur Spine J. 2015 Oct;24(10):2209-19
references.pmid: 25542383
references.citation: Eur Spine J. 2007 Aug;16(8):1193-202
references.pmid: 17252218
references.citation: Spine (Phila Pa 1976). 2005 Aug 15;30(16):1899-908
references.pmid: 16103863
references.citation: Spine (Phila Pa 1976). 1997 Feb 1;22(3):324-33
references.pmid: 9051895
references.citation: J Neurosurg Spine. 2006 May;4(5):409-14
references.pmid: 16703909
references.citation: Spine J. 2014 Nov 1;14(11):2608-17
references.pmid: 24561037
references.citation: Spine (Phila Pa 1976). 2000 Nov 15;25(22):2940-52; discussion 2952
references.pmid: 11074683
references.citation: Orthop Traumatol Surg Res. 2014 Feb;100(1):119-26
references.pmid: 24394919
references.citation: J Surg Oncol. 2014 Mar;109(3):184-8
references.pmid: 24249252
references.citation: Neurosurgery. 2012 Aug;71(2):357-64; discussion 364
references.pmid: 22569060
references.citation: Spine (Phila Pa 1976). 2009 Nov 15;34(24):2700-4
references.pmid: 19910774
references.citation: J Spinal Disord Tech. 2011 Jun;24(4):230-4
references.pmid: 20634724
references.citation: Eur Rev Med Pharmacol Sci. 2011 Jul;15(7):831-9
references.pmid: 21780553
references.citation: Spine (Phila Pa 1976). 1997 May 1;22(9):1036-44
references.pmid: 9152458
references.citation: Spine (Phila Pa 1976). 2012 Jan 15;37(2):119-26
references.pmid: 22037533
references.citation: Spine (Phila Pa 1976). 2009 Sep 15;34(20):2233-9
references.pmid: 19752710
references.citation: Spine J. 2009 Nov;9(11):928-35
references.pmid: 19716772
references.citation: J Neurosurg Spine. 2005 Aug;3(2):106-10
references.pmid: 16370299
references.citation: J Clin Oncol. 1984 Mar;2(3):187-93
references.pmid: 6699671
references.citation: Spine (Phila Pa 1976). 2009 Oct 15;34(22 Suppl):S26-30
references.pmid: 19829274
references.citation: J Neurosurg Spine. 2005 Aug;3(2):111-22
references.pmid: 16370300
references.citation: Spine (Phila Pa 1976). 2009 Oct 15;34(22 Suppl):S39-47
references.pmid: 19829276
references.citation: J Neurosurg Spine. 2015 Jun;22(6):563-70
references.pmid: 25815809
references.citation: Clin Orthop Relat Res. 2003 Oct;(415):4-18
references.pmid: 14612624
references.citation: Bone Joint J. 2014 Dec;96-B(12):1693-8
references.pmid: 25452375
references.citation: J Neurooncol. 2014 Oct;120(1):171-8
references.pmid: 25059450
references.citation: Spine (Phila Pa 1976). 2011 May 1;36(10):830-6
references.pmid: 20714276
references.citation: Spine (Phila Pa 1976). 2012 Mar 1;37(5):420-8
references.pmid: 22366943
references.citation: Spine J. 2012 Jan;12(1):22-34
references.pmid: 22209243
references.citation: J Neurosurg Spine. 2008 Aug;9(2):120-8
references.pmid: 18764743
references.citation: Spine (Phila Pa 1976). 2009 Oct 15;34(22 Suppl):S31-8
references.pmid: 19829275
references.citation: J Neurosurg Spine. 2008 Dec;9(6):593-9
references.pmid: 19035755
references.citation: Spine J. 2015 Feb 1;15(2):222-9
references.pmid: 25195977
references.citation: Acta Orthop Scand. 1976 Dec;47(6):635-42
references.pmid: 1015258
references.citation: Clin Orthop Relat Res. 1986 Mar;(204):9-24
references.pmid: 3456859
references.citation: J Plast Reconstr Aesthet Surg. 2014 Sep;67(9):1257-66
references.pmid: 24907194
references.citation: Spine J. 2015 Aug 1;15(8):1728-37
references.pmid: 25862510
references.citation: Neurosurgery. 2010 Aug;67(2):435-44; discussion 444-5
references.pmid: 20644431
references.citation: J Surg Oncol. 2010 May 1;101(6):447-50
references.pmid: 20401914