Total en bloc spondylectomy is worth doing in complete paralysis spinal giant cell tumor, a minimum 1-year follow-up

J Orthop Surg (Hong Kong). 2021 Jan-Apr;29(1):23094990211005900. doi: 10.1177/23094990211005900.

Abstract

Objective: To investigate the neurological recovery of Frankel A spinal giant cell tumor (GCT) patients after they had received a Total En Bloc Spondylectomy (TES).

Materials and methods: We retrospectively recorded data of three patients (two females) with mobile spine GCT (T6, T10, and L2) Enneking stage III with complete paralysis before surgery, who had undergone TES in our institute from January 2018 to September 2020. The duration of neurologic recovery to Frankel E was the primary outcome. The intra-operative blood loss, operative time, operative-related complications, and the local recurrence were the secondary outcomes.

Results: The duration of suffering from Frankel A to TES surgery was 2 months for the T6 patient, 3 weeks for the T10 patient, and 1 month for the L2 patient. Three patients had achieved full neurological recovery to Frankel E within 6 months after TES (T6 for 5 months, T10 for 3 months, and L2 for 3 months). The average blood loss was 2833.33 ml and the mean operative time was 400 min. Up until the last follow-up (13-25 months), no evidence of local recurrences had been found in any of the three patients.

Conclusion: Frankel A spinal GCT patients can achieve full neurological recovery after TES, if the procedure is performed within 3 months after complete paraplegia. TES can effectively control any local recurrences.

Keywords: Enneking III; Frankel A; TES; neurological recovery; spinal giant cell tumor; total en bloc spondylectomy.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bone Neoplasms / complications
  • Bone Neoplasms / surgery*
  • Diskectomy / methods*
  • Female
  • Follow-Up Studies
  • Giant Cell Tumor of Bone / complications
  • Giant Cell Tumor of Bone / surgery*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / prevention & control
  • Paralysis / etiology
  • Paralysis / surgery*
  • Retrospective Studies
  • Spinal Neoplasms / complications
  • Spinal Neoplasms / surgery*
  • Spine / surgery
  • Treatment Outcome