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Risk Factors for Instrumentation Failure After Total En Bloc Spondylectomy of Thoracic and Lumbar Spine Tumors Using Titanium Mesh Cage for Anterior Reconstruction.

使用钛网笼进行前路重建的胸腰椎肿瘤全脊椎切除术后器械失败的危险因素。

  • 影响因子:1.52
  • DOI:10.1016/j.wneu.2019.11.057
  • 作者列表:"Li Z","Wei F","Liu Z","Liu X","Jiang L","Yu M","Xu N","Wu F","Dang L","Zhou H","Li Z
  • 发表时间:2020-03-01
Abstract

OBJECTIVE:The present study investigated the risk factors for instrumentation failure (IF) after total en bloc spondylectomy (TES) of thoracic and lumbar spine tumors using a titanium mesh cage (TMC) for anterior reconstruction. METHODS:The data from patients who had undergone TES for thoracic and lumbar spine tumors in our institution were retrospectively reviewed. Anterior reconstruction was performed using a TMC filled with morcelized allograft or morcelized autograft. Posterior reconstruction was performed using pedicle fixation. Survival analysis from TES to IF was conducted. The Kaplan-Meier method was used for univariate analysis. Factors of statistical significance were included in the multivariate analysis using Cox regression analysis. RESULTS:A total of 30 patients (20 men and 10 women), with a mean age of 37.1 ± 14.3 years (range, 14-65 years) were included. The mean follow-up period was 41.8 ± 21.3 months (range, 13-120 months). Bone fusion was achieved in 23 patients (76.7%). IF occurred in 8 patients. The mean interval from TES to the first IF was 31.8 ± 15.1 months (range, 13-64 months). On univariable analysis, a body mass index >28 kg/m2, perioperative radiotherapy, and the TMC in an oblique position were associated with IF. On multivariable analysis, these 3 factors were entered into the Cox regression model and were also significant. CONCLUSIONS:The use of TES can achieve durable oncological control. However, IF, a not uncommon late complication that leads to reoperation, should be a cause for concern. We found perioperative radiotherapy, a TMC in an oblique position, and a body mass index >28 kg/m2 were significant predictive factors for IF.

摘要

目的: 本研究调查了使用钛网笼 (TMC) 的胸腰椎肿瘤全脊椎切除术 (TES) 后器械失效 (IF) 的危险因素。用于前路重建。 方法: 回顾性分析我机构因胸腰椎肿瘤接受TES治疗的患者资料。使用填充有morcelized同种异体移植物或morcelized自体移植物的TMC进行前路重建。使用椎弓根固定进行后路重建。进行了从TES到IF的生存分析。采用Kaplan-Meier法进行单因素分析。将具有统计学意义的因素纳入Cox回归分析的多因素分析。 结果: 共纳入 30 例患者 (20 例男性和 10 例女性),平均年龄 37.1 ± 14.3 岁 (范围 14-65 岁)。平均随访时间为 41.8 ± 21.3 个月 (范围 13-120 个月)。骨性融合 23 例 (76.7%)。若发生于 8 例患者。从TES到第一个IF的平均间隔为 31.8 ± 15.1 个月 (范围为 13-64 个月)。在单变量分析中,体重指数> 28千克kg/m2 、围手术期放疗和斜位TMC与IF相关。在多变量分析中,这 3 个因素进入Cox回归模型,也是显著的。 结论: 使用TES可以实现持久的肿瘤学控制。然而,如果导致再次手术的晚期并发症并不罕见,应该引起关注。我们发现围手术期放疗、斜位TMC和体重指数> 28千克kg/m2 是IF的显著预测因素。

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影响因子:1.41
发表时间:2020-03-01
DOI:10.1177/1078155219842277
作者列表:["Gyori DJ","Bullington SM","Crawford BS","Vernon VP"]

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影响因子:2.83
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骨肿瘤方向

骨肿瘤是发生于骨骼或其附属组织的肿瘤。有良性,恶性之分,良性骨肿瘤易根治,预后良好,恶性骨肿瘤发展迅速,预后不佳,死亡率高。

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