Major complications and sequelae after total en bloc spondylectomy for malignant spinal tumors

Morio Matsumoto, Tomohiro Hikata, Akio Iwanami, Naobumi Hosogane, Koota Watanabe, Ken Ishii, Masaya Nakamura, Yoshiaki Toyama

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Abstract

This retrospective study looked at 33 consecutive patients with malignant, aggressive tumors in the thoracic and lumbar spine who underwent TES (24 men and 9 women; mean age 49.9 years; mean follow-up 3.6 years; 14 primary tumors and 19 metastatic tumors). TES was performed by a posterior-only approach in 15 patients and by a combined anterior and posterior approach in 18 patients. We classified complications as intraoperative, early (within 1 month after surgery), or late (>1 month after surgery), and examined the relationships between major complications and potentially related factors. Ten died of disease at 22.3 months after TES. Local recurrence was observed in 8 patients (24%) at an average of 15.4 months. Thirty-one major complications occurred in 24 patients (72.7%). There were 3 intraoperative, 17 early, and 11 late complications. Intraoperative complications included injury to the segmental artery, to the aorta, and to the spinal cord in 1 patient each. Early complications included prolonged chest tube drainage, cerebrospinal fluid leakage, and monoplegia due to the severing of nerve roots in 3 patients each, and pulmonary embolism, recurrent nerve palsy, pneumonia, endplate fracture, implant dislodgement, gastric ulcer, and ileus in 1 patient each. Late complications included implant failures in 8 patients and infection in 3 patients. Major complications were significantly associated with major blood loss (P = 0.047). TES was frequently associated with major intraoperative, early, and late postoperative complications; most complications were managed successfully.

Original languageEnglish
Pages (from-to)442-451
Number of pages10
JournalNeurosurgery Quarterly
Volume25
Issue number4
Publication statusPublished - 2015

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Neoplasms
Intraoperative Complications
Chest Tubes
Hemiplegia
Ileus
Stomach Ulcer
Pulmonary Embolism
Paralysis
Aorta
Drainage
Spinal Cord
Pneumonia
Spine
Thorax
Retrospective Studies
Arteries
Recurrence
TES
Wounds and Injuries
Infection

Keywords

  • Complication
  • Malignant
  • Spinal tumor
  • Total en bloc spondylectomy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Major complications and sequelae after total en bloc spondylectomy for malignant spinal tumors. / Matsumoto, Morio; Hikata, Tomohiro; Iwanami, Akio; Hosogane, Naobumi; Watanabe, Koota; Ishii, Ken; Nakamura, Masaya; Toyama, Yoshiaki.

In: Neurosurgery Quarterly, Vol. 25, No. 4, 2015, p. 442-451.

Research output: Contribution to journalArticle

Matsumoto, Morio ; Hikata, Tomohiro ; Iwanami, Akio ; Hosogane, Naobumi ; Watanabe, Koota ; Ishii, Ken ; Nakamura, Masaya ; Toyama, Yoshiaki. / Major complications and sequelae after total en bloc spondylectomy for malignant spinal tumors. In: Neurosurgery Quarterly. 2015 ; Vol. 25, No. 4. pp. 442-451.
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