Artikel
Complications of cervical and thoracic corpectomies: Retrospective outcome analysis of 72 patients
Suche in Medline nach
Autoren
-
Sebastian Hartmann
- Department für Neurochirurgie, Medizinische Universität Innsbruck
-
Christoph Wipplinger
- Department für Neurochirurgie, Medizinische Universität Innsbruck
-
Pujan Kavakebi
- Department für Neurochirurgie, Medizinische Universität Innsbruck
-
Anja Tschugg
- Department für Neurochirurgie, Medizinische Universität Innsbruck
-
Jochen Obernauer
- Department für Neurochirurgie, Medizinische Universität Innsbruck
-
Claudius Thomé
- Department für Neurochirurgie, Medizinische Universität Innsbruck
| Veröffentlicht: | 2. Juni 2015 |
|---|
Gliederung
Text
Objective: Cervical and thoracic corpectomies are increasingly used to treat degenerative, neoplastic, inflammatory and traumatic lengthy spinal diseases. The postoperative results are thought to correlate mainly with the number of resected vertebral bodies, especially in the cervical spine. Data on the thoracic approaches are still scarce. Thus, we aimed at analyzing complications and early outcome of these procedures with a focus on implant-related problems.
Method: 72 consecutive patients, who were treated in our department from 2011 to 2014 and were available for a minimum follow-up of 6 months, were included in this retrospective evaluation. 48 cervical and 25 thoracic corpectomies were performed. The median age was 60 ± 13 years. The average number of resected levels was 1.2. Intraoperative blood-loss, red cell-transfusions, duration of surgery and usage of drains were investigated and correlated with intra- and postoperative complications.
Results: The average duration of surgery was 267 ± 109 min with 255 min and 287 min for cervical and thoracic corpectomies, respectively. The mean blood-loss amounted to 551 ml for the cervical and 1191 ml for the thoracic cases. The overall complication rate was 31% (22 patients) and affected 29% and 25% of all cervical and thoracic approaches, respectively. 15 patients with complications needed revision surgery, 8 (53%) of them had implant-related complications. Twice as many of the cervical 2-level corpectomies had revision surgery compared to 1-level approaches. The average time from first to second surgery was 114 days.
Conclusions: Corpectomies in the cervical and thoracic spine still remain procedures with a high complication rate mainly represented by implant-related failures. Especially cervical approaches seem to be most vulnerable to implant-related complications due to plate-/screw-/cage displacement or cage subsidence. These difficulties increase with the number of resected levels due to biomechanical instability mostly associated with revision surgery. Thus, our results support the use of circumferential approaches for 2- or more level cervical corpectomies.
