Transpedicular partial corpectomy without anterior vertebral reconstruction in thoracic spinal metastases

Spine (Phila Pa 1976). 2007 Oct 15;32(22):E623-6. doi: 10.1097/BRS.0b013e3181573eea.

Abstract

Study design: We retrospectively reviewed surgical results of posterolateral transpedicular partial corpectomy without anterior vertebral reconstruction in 23 consecutive patients with symptomatic metastatic spinal cord compression at thoracic spine.

Objective: To evaluate postoperative outcomes and survival rates of patients undergoing transpedicular partial corpectomy without anterior vertebral reconstruction.

Summary of background data: The need for anterior reconstruction after radical resection of vertebral body tumors has been emphasized by several authors. However, the stability of thoracic spine is substantially increased by the rib cage. The role of reconstruction may be not necessary in thoracic spine when partial corpectomy is performed.

Methods: From November 2001 to November 2006, 23 patients with symptomatic metastatic spinal cord compression at thoracic spine underwent palliative surgery using a transpedicular partial corpectomy without anterior vertebral reconstruction. The indication for surgery was neurologic progression due to spinal cord compression.

Results: Patients ranged in age from 20 to 88 years (mean, 57.0 years). Neurologic improvement by at least one Frankel grade was noted in 19 of 23 cases (82.6%). Overall, 73.9% of patients (17 of 23) could walk after surgery. There was no intraoperative mortality. Median survival time was 11.3 months. There was no implant failure.

Conclusion: The results of this study suggest that the stability of implants can be maintained up to 55.8 months without anterior vertebral reconstruction in thoracic spine.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Decompression, Surgical / instrumentation
  • Decompression, Surgical / methods
  • Decompression, Surgical / mortality
  • Disease Progression
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neurosurgical Procedures / instrumentation
  • Neurosurgical Procedures / methods*
  • Neurosurgical Procedures / mortality
  • Palliative Care
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Spinal Cord Compression / etiology
  • Spinal Cord Compression / physiopathology
  • Spinal Cord Compression / surgery*
  • Spinal Neoplasms / secondary*
  • Spinal Neoplasms / surgery*
  • Survival Rate
  • Thoracic Vertebrae / pathology*
  • Thoracic Vertebrae / physiopathology
  • Thoracic Vertebrae / surgery*
  • Treatment Outcome