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Archives of Orthopaedic and Trauma Surgery

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Open Access 08-04-2024 | Orthopaedic Surgery

En-bloc spondylectomy in the lumbar spine: indications, results and complications in a series of 47 patients affected by primary malignant bone tumors

Authors: Alessandro Luzzati, Stefano Conti, Isabella Sperduti, Alessandra Scotto Di Uccio, Simone Mazzoli, Luca Cannavò, Gennaro Scotto, Carmine Zoccali

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 5/2024

Abstract

Introduction

Wide Surgery is the reference treatment for malignant and aggressive benign primary bone tumors in the spine. When located in the lumbar spine, En-Bloc Spondylectomy (EBS) remains a complex challenge. Moreover, surgery is complicated by the presence of the diaphragm in the thoracolumbar junction and the hinderance of the iliac wings at the lumbosacral levels. Therefore, EBS in the lumbar spine frequently requires combined approaches.

The purpose of this study is to describe clinical presentation, tumor characteristics and results of a series of 47 consecutive patients affected by malignant primary bone tumors of the lumbar spine who underwent EBS.

Materials and methods

47 patients were reviewed. Complications were distinguished in early and late whether they occurred before or after 30 days from surgery.

Overall survival (OS), disease-free survival (DFS) and local recurrence-free survival (LRFS) were calculated by the Kaplan–Meier product-limit method from surgery until relapse or death.

Results

27 patients presented to observation after a first intralesional approach in a non-specialized center. Chordoma was the most represented histotype. Vertebrectomies were: 23 one-level, 10 two-level, 12 three-level and 2 four-level. Reconstructions were always carried out with screws and rods. The main postoperative complication was blood loss, while hardware failure was the main long-term complication.

The 5-year LRFS was 75.5%, the 5-year DFS was 54.3%, and 5-year OS was 63.6%.

Conclusions

The surgical margin obtained during the index surgery was statistically associated with Local Recurrence, DFS and OS, underlining the importance of treating patients in reference centers.

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Title: En-bloc spondylectomy in the lumbar spine: indications, results and complications in a series of 47 patients affected by primary malignant bone tumors
Authors: Alessandro Luzzati
Stefano Conti
Isabella Sperduti
Alessandra Scotto Di Uccio
Simone Mazzoli
Luca Cannavò
Gennaro Scotto
Carmine Zoccali
Publication date: 08-04-2024
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 5/2024
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-024-05274-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

En-bloc spondylectomy in the lumbar spine: indications, results and complications in a series of 47 patients affected by primary malignant bone tumors

Abstract

Introduction

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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