Artikel
Complication profile after surgical therapy in instable tumorous lesions of the cervicothoracic junction of the spine
Komplikationsprofil nach operativer Therapie instabiler tumoröser Läsionen des zervikothorakalen Übergangs der Wirbelsäule
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Veröffentlicht: | 25. Mai 2022 |
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Gliederung
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Objective: Tumorous lesions causing instability in the cervicothoracic junction of the spine require complex surgical strategies due to the anatomy and the high biomechanical load of this part of the spine. Aim of this retrospective monocentric study was to evaluate and quantify the complication rate after stabilizing surgical treatment of the cervicothoracic junction.
Methods: Records of all consecutive patients receiving surgical treatment for tumorous lesions of the spinal levels C7 – T2 between 2010 – 2019 were evaluated. Relevant epidemiological, clinical and surgical data were assessed. Spinal Instability Neoplastic Score Score (SINS) was calculated on the basis of preoperative imaging. Complications were grouped in general and implant associated complications.
Results: Records of a total of 26 patients were analyzed. Mean age of the 17 male and 9 female patients was 60 years. 23 patients were treated for metastases, 2 for plasmacytoma and 1 for Giant-cell-tumor of the bone. Mean preoperative Karnofsky Performance Score was 60 %. Mean preoperative SINS was 14. Instability of the spine was the main indication for surgical therapy in 24 patients (92 %). Of 18 patients (69 %) with preoperative neurological deficits surgical therapy lead to partial improvement in 8 (44 %) and complete neurological improvement in 4 (22 %) cases. In 14 (54 %) cases surgery-related complications occurred. General complications occurred in 10 cases (38 %): Wound healing disorders in 8 cases (30 %), postoperative hematomas needing surgical evacuation in 2 cases (7.7 %). Implant associated complications occurred in 6 cases (23 %): Malposition of implants in 3 cases (11.5 %), hardware failure in 3 cases (11.5 %). In-hospital mortality rate was 11.5 %.
Conclusion: Both general as well as implant associated complication rates were high. In combination with a high in-hospital mortality rate our data underline the challenging demands placed on the surgical treatment of tumorous lesions of the cervicothoracic spine.