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Comparison of subtotal vertebral resection with reconstruction and percutaneous vertebroplasty for treatment of metastasis in the lumbar spine.
Br J Neurosurg. 2020 Jun; 34(3):308-312.BJ

Abstract

Purpose:

Tumor metastasis in the spine can cause pain and fractures, leading to deformities, and deficits in movement, sensation, and bowel/bladder function. Percutaneous vertebroplasty (PVP) and subtotal vertebral resection with reconstruction (SVR) are suitable treatments, but their relative clinical efficacy is uncertain. The purpose of this retrospective cohort study was to compare the management and clinical effect of SVR for lumbar metastatic tumor with PVP.

Methods:

Sixty-seven patients (mean age: 58.6 years) with metastases in the lumbar spine received SVR or PVP at our institution between 2010 and 2013. Thirty-three patients received SVR via a posterior approach, in which vertebrae were resected, with the anterior and lateral walls retained using polymethylmethacrylate (PMMA), followed by reconstruction and pedicle screw fixation. Thirty-four patients received PVP via the vertebral pedicle. Patients were followed for 3-26 months.

Results:

None of the patients experienced serious complications after surgery, and all patients experienced significant amelioration of pain. Twelve patients (8 in the PVP group and 4 in the SVR group) died during the follow-up, and the survival time was significantly longer in the SVR group. Two patients in the SVR group and 7 patients in the PVP groups experienced recurrence during follow-up, but the groups had no significant difference in local recurrence. Both treatments significantly reduced scores for pain on a visual analog scale (pain-VAS) and disability (Oswestry Disability Index [ODI]), and increased performance status (Karnofsky Performance Status [KPS]). Compared with the PVP group, the SVR group had better ODI score at 1 month and 3 months after surgery and a higher KPS score at 1 month after surgery. The two groups had no significant difference in pain-VAS scores during follow-up.

Conclusions:

SVR is a reliable treatment for lumbar metastatic tumor and provides good survival rate and satisfying follow-up results.

Authors+Show Affiliations

Department of Orthopaedics, People Hospital of Wuhan University, Wuhan, China.Department of Orthopedic Surgery, Changhai Hospital of Second Military Medical University, Shanghai, China.Department of Orthopaedics, People Hospital of Wuhan University, Wuhan, China.Department of Orthopaedics, People Hospital of Wuhan University, Wuhan, China.Department of Orthopaedics, People Hospital of Wuhan University, Wuhan, China.Department of Orthopaedics, People Hospital of Wuhan University, Wuhan, China.Department of Orthopaedics, People Hospital of Wuhan University, Wuhan, China.Department of Orthopaedics, PLA No. 306 Hospital, Beijing, China.Department of Orthopaedics, People Hospital of Wuhan University, Wuhan, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32614272

Citation

Tao, Fenghua, et al. "Comparison of Subtotal Vertebral Resection With Reconstruction and Percutaneous Vertebroplasty for Treatment of Metastasis in the Lumbar Spine." British Journal of Neurosurgery, vol. 34, no. 3, 2020, pp. 308-312.
Tao F, Shi Z, Tao H, et al. Comparison of subtotal vertebral resection with reconstruction and percutaneous vertebroplasty for treatment of metastasis in the lumbar spine. Br J Neurosurg. 2020;34(3):308-312.
Tao, F., Shi, Z., Tao, H., Wei, A., Tao, H., Cao, H., Zhao, Y., Zhang, Y., & Xiang, W. (2020). Comparison of subtotal vertebral resection with reconstruction and percutaneous vertebroplasty for treatment of metastasis in the lumbar spine. British Journal of Neurosurgery, 34(3), 308-312. https://doi.org/10.1080/02688697.2020.1729959
Tao F, et al. Comparison of Subtotal Vertebral Resection With Reconstruction and Percutaneous Vertebroplasty for Treatment of Metastasis in the Lumbar Spine. Br J Neurosurg. 2020;34(3):308-312. PubMed PMID: 32614272.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of subtotal vertebral resection with reconstruction and percutaneous vertebroplasty for treatment of metastasis in the lumbar spine. AU - Tao,Fenghua, AU - Shi,Zhicai, AU - Tao,Haiying, AU - Wei,Ailin, AU - Tao,Hai, AU - Cao,Hui, AU - Zhao,Yingchun, AU - Zhang,Ye, AU - Xiang,Wei, PY - 2020/7/3/entrez PY - 2020/7/3/pubmed PY - 2020/7/3/medline KW - Percutaneous vertebroplasty KW - lumbar KW - metastatic tumor KW - subtotal vertebral resection with reconstruction KW - surgery SP - 308 EP - 312 JF - British journal of neurosurgery JO - Br J Neurosurg VL - 34 IS - 3 N2 - Purpose: Tumor metastasis in the spine can cause pain and fractures, leading to deformities, and deficits in movement, sensation, and bowel/bladder function. Percutaneous vertebroplasty (PVP) and subtotal vertebral resection with reconstruction (SVR) are suitable treatments, but their relative clinical efficacy is uncertain. The purpose of this retrospective cohort study was to compare the management and clinical effect of SVR for lumbar metastatic tumor with PVP.Methods: Sixty-seven patients (mean age: 58.6 years) with metastases in the lumbar spine received SVR or PVP at our institution between 2010 and 2013. Thirty-three patients received SVR via a posterior approach, in which vertebrae were resected, with the anterior and lateral walls retained using polymethylmethacrylate (PMMA), followed by reconstruction and pedicle screw fixation. Thirty-four patients received PVP via the vertebral pedicle. Patients were followed for 3-26 months.Results: None of the patients experienced serious complications after surgery, and all patients experienced significant amelioration of pain. Twelve patients (8 in the PVP group and 4 in the SVR group) died during the follow-up, and the survival time was significantly longer in the SVR group. Two patients in the SVR group and 7 patients in the PVP groups experienced recurrence during follow-up, but the groups had no significant difference in local recurrence. Both treatments significantly reduced scores for pain on a visual analog scale (pain-VAS) and disability (Oswestry Disability Index [ODI]), and increased performance status (Karnofsky Performance Status [KPS]). Compared with the PVP group, the SVR group had better ODI score at 1 month and 3 months after surgery and a higher KPS score at 1 month after surgery. The two groups had no significant difference in pain-VAS scores during follow-up.Conclusions: SVR is a reliable treatment for lumbar metastatic tumor and provides good survival rate and satisfying follow-up results. SN - 1360-046X UR - https://www.unboundmedicine.com/medline/citation/32614272/Comparison_of_subtotal_vertebral_resection_with_reconstruction_and_percutaneous_vertebroplasty_for_treatment_of_metastasis_in_the_lumbar_spine L2 - http://www.tandfonline.com/doi/full/10.1080/02688697.2020.1729959 DB - PRIME DP - Unbound Medicine ER -
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