Changes in sagittal alignment after surgical excision of thoracic spinal cord tumors in adults

Yoshiomi Kobayashi, Soya Kawabata, Yuichiro Nishiyama, Osahiko Tsuji, Eijiro Okada, Nobuyuki Fujita, Mitsuru Yagi, Koota Watanabe, Morio Matsumoto, Masaya Nakamura, Narihito Nagoshi

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Abstract

Study design: Retrospective chart audit. Objectives: This study investigated changes in sagittal alignment in adults after excision of thoracic spinal cord tumors without spinal fixation. Setting: Single-center study at an academic orthopedic department in Japan. Methods: We retrospectively reviewed records for 32 adults who underwent excision of thoracic spinal cord tumors by multilevel laminectomies without fixation. The participants were divided according to whether the tumor was in the upper (T1–4), middle (T5–8), or lower (T9–12) thoracic spine. We analyzed parameters such as age, sex, time in surgery and estimated blood loss, follow-up period, and preoperative and follow-up the Japanese Orthopaedic Association (JOA) scores and radiographs. Results: Postoperative T1-12 kyphotic changes did not correlate with age, the number of resected laminae, or preoperative T1-12 kyphosis. JOA recovery rates were similar regardless of the tumor location. Participants with tumors in the upper thoracic spine had significant postoperative increases in T1–4 kyphosis, T1 slope (p <.05, respectively). In contrast, there were no significant changes in alignment in participants with tumors in the middle or lower thoracic spine. Conclusion: Even without fixation, sagittal alignment did not change after surgery to excise tumors in the middle and lower thoracic spine, indicating that fixation may not be necessary when excising spinal cord tumors in this region. In contrast, postoperative kyphosis may increase when the tumor is in the upper thoracic spine.

Original languageEnglish
JournalSpinal Cord
DOIs
Publication statusAccepted/In press - 2019 Jan 1

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Spinal Cord Neoplasms
Thorax
Spine
Kyphosis
Neoplasms
Orthopedics
Preoperative Period
Laminectomy
Japan
Retrospective Studies

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

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title = "Changes in sagittal alignment after surgical excision of thoracic spinal cord tumors in adults",
abstract = "Study design: Retrospective chart audit. Objectives: This study investigated changes in sagittal alignment in adults after excision of thoracic spinal cord tumors without spinal fixation. Setting: Single-center study at an academic orthopedic department in Japan. Methods: We retrospectively reviewed records for 32 adults who underwent excision of thoracic spinal cord tumors by multilevel laminectomies without fixation. The participants were divided according to whether the tumor was in the upper (T1–4), middle (T5–8), or lower (T9–12) thoracic spine. We analyzed parameters such as age, sex, time in surgery and estimated blood loss, follow-up period, and preoperative and follow-up the Japanese Orthopaedic Association (JOA) scores and radiographs. Results: Postoperative T1-12 kyphotic changes did not correlate with age, the number of resected laminae, or preoperative T1-12 kyphosis. JOA recovery rates were similar regardless of the tumor location. Participants with tumors in the upper thoracic spine had significant postoperative increases in T1–4 kyphosis, T1 slope (p <.05, respectively). In contrast, there were no significant changes in alignment in participants with tumors in the middle or lower thoracic spine. Conclusion: Even without fixation, sagittal alignment did not change after surgery to excise tumors in the middle and lower thoracic spine, indicating that fixation may not be necessary when excising spinal cord tumors in this region. In contrast, postoperative kyphosis may increase when the tumor is in the upper thoracic spine.",
author = "Yoshiomi Kobayashi and Soya Kawabata and Yuichiro Nishiyama and Osahiko Tsuji and Eijiro Okada and Nobuyuki Fujita and Mitsuru Yagi and Koota Watanabe and Morio Matsumoto and Masaya Nakamura and Narihito Nagoshi",
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AU - Kobayashi, Yoshiomi

AU - Kawabata, Soya

AU - Nishiyama, Yuichiro

AU - Tsuji, Osahiko

AU - Okada, Eijiro

AU - Fujita, Nobuyuki

AU - Yagi, Mitsuru

AU - Watanabe, Koota

AU - Matsumoto, Morio

AU - Nakamura, Masaya

AU - Nagoshi, Narihito

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N2 - Study design: Retrospective chart audit. Objectives: This study investigated changes in sagittal alignment in adults after excision of thoracic spinal cord tumors without spinal fixation. Setting: Single-center study at an academic orthopedic department in Japan. Methods: We retrospectively reviewed records for 32 adults who underwent excision of thoracic spinal cord tumors by multilevel laminectomies without fixation. The participants were divided according to whether the tumor was in the upper (T1–4), middle (T5–8), or lower (T9–12) thoracic spine. We analyzed parameters such as age, sex, time in surgery and estimated blood loss, follow-up period, and preoperative and follow-up the Japanese Orthopaedic Association (JOA) scores and radiographs. Results: Postoperative T1-12 kyphotic changes did not correlate with age, the number of resected laminae, or preoperative T1-12 kyphosis. JOA recovery rates were similar regardless of the tumor location. Participants with tumors in the upper thoracic spine had significant postoperative increases in T1–4 kyphosis, T1 slope (p <.05, respectively). In contrast, there were no significant changes in alignment in participants with tumors in the middle or lower thoracic spine. Conclusion: Even without fixation, sagittal alignment did not change after surgery to excise tumors in the middle and lower thoracic spine, indicating that fixation may not be necessary when excising spinal cord tumors in this region. In contrast, postoperative kyphosis may increase when the tumor is in the upper thoracic spine.

AB - Study design: Retrospective chart audit. Objectives: This study investigated changes in sagittal alignment in adults after excision of thoracic spinal cord tumors without spinal fixation. Setting: Single-center study at an academic orthopedic department in Japan. Methods: We retrospectively reviewed records for 32 adults who underwent excision of thoracic spinal cord tumors by multilevel laminectomies without fixation. The participants were divided according to whether the tumor was in the upper (T1–4), middle (T5–8), or lower (T9–12) thoracic spine. We analyzed parameters such as age, sex, time in surgery and estimated blood loss, follow-up period, and preoperative and follow-up the Japanese Orthopaedic Association (JOA) scores and radiographs. Results: Postoperative T1-12 kyphotic changes did not correlate with age, the number of resected laminae, or preoperative T1-12 kyphosis. JOA recovery rates were similar regardless of the tumor location. Participants with tumors in the upper thoracic spine had significant postoperative increases in T1–4 kyphosis, T1 slope (p <.05, respectively). In contrast, there were no significant changes in alignment in participants with tumors in the middle or lower thoracic spine. Conclusion: Even without fixation, sagittal alignment did not change after surgery to excise tumors in the middle and lower thoracic spine, indicating that fixation may not be necessary when excising spinal cord tumors in this region. In contrast, postoperative kyphosis may increase when the tumor is in the upper thoracic spine.

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