Open AccessSpondylectomy in the treatment of neoplastic spinal lesions – A retrospective outcome analysis of 582 patients using a patient-level meta-analysis
Author(s) -
Alexander Spiessberger,
Nicholas Dietz,
Varun Arvind,
Mansoor Nasim,
Basil E. Grüter,
Edin Nevzati,
Silvia Höfer
Publication year - 2021
Publication title -
journal of craniovertebral junction and spine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.38
H-Index - 23
eISSN - 0976-9285
pISSN - 0974-8237
DOI - 10.4103/jcvjs.jcvjs_211_20
Subject(s) - medicine , etiology , chordoma , surgery , complication , odds ratio , retrospective cohort study , lesion , sarcoma , pathology
This study aims at identifying predictors of postoperative complications, lesion recurrence, and overall survival in patients undergoing en bloc spondylectomy (EBS) for spinal tumors. For this purpose a systematic review of the literature was conducted and patient-level data extracted. Linear-regression models were calculated to predict postoperative complications, lesion recurrence and overall survival based on age, tumor etiology, surgical approach, mode of resection (extra- vs. intralesional), tumor extension, and number of levels treated. A total of 582 patients were identified from the literature: 45% of females, median age 46 years (5-78); most common etiologies were: sarcoma (46%), metastases (31%), chordoma (11%); surgical approach was anterior (2.5%), combined (45%), and posterior (52.4%); 68.5% underwent EBS; average levels resected were 1.6 (1-6); average survival was 2.6 years; Complication rate was 17.7%. The following significant correlations were found: postoperative complications and resection mode (Odds ratio [OR] 1.35) as well as number of levels treated (OR 1.35); tumor recurrence and resection mode (OR 0.78); 5-year survival and age (OR 0.79), tumor grade (OR 0.65), tumor stage at diagnosis (OR 0.79), and resection mode (OR 1.68). EBS was shown to improve survival, decreases recurrence rates but also has a higher complication rate. Interestingly, the complication rate was not influenced by tumor extension or tumor etiology.