Revision surgery for instrumentation failure after total en bloc spondylectomy: a retrospective case series

被引：13

作者：

Shinmura, Kazuya ^{[1
]}

Kato, Satoshi ^{[1
]}

Demura, Satoru ^{[1
]}

Yokogawa, Noriaki ^{[1
]}

Yonezawa, Noritaka ^{[1
]}

Shimizu, Takaki ^{[1
]}

Oku, Norihiro ^{[1
]}

Kitagawa, Ryo ^{[1
]}

Handa, Makoto ^{[1
]}

Annen, Ryohei ^{[1
]}

Murakami, Hideki ^{[2
]}

Tsuchiya, Hiroyuki ^{[1
]}

机构：

[1] Kanazawa Univ, Dept Orthoped Surg, Grad Sch Med Sci, 13-1 Takara Machi, Kanazawa, Ishikawa 9200961, Japan

[2] Nagoya City Univ, Grad Sch Med Sci, Dept Orthoped Surg, Nagoya, Aichi, Japan

来源：

BMC MUSCULOSKELETAL DISORDERS | 2020年 / 21卷 / 01期

基金：

日本学术振兴会;

关键词：

Total en bloc spondylectomy; Instrumentation failure; Revision surgery; Cobalt chromium; Bone fusion; Liquid nitrogen; SURGICAL-TECHNIQUES; LUMBAR SPINE; TUMORS;

D O I：

10.1186/s12891-020-03622-6

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Background: There have been several reports of instrumentation failure after three-column resections such as total en bloc spondylectomy (TES) for spinal tumors; however, clinical outcomes of revision surgery for instrumentation failure after TES are seldom reported. Therefore, this study assessed the clinical outcomes of revision surgery for instrumentation failure after TES. Methods: This study employed a retrospective case series in a single center and included 61 patients with spinal tumors who underwent TES between 2010 and 2015 and were followed up for > 2 years. Instrumentation failure rate, back pain, neurological deterioration, ambulatory status, operation time, blood loss, complications, bone fusion after revision surgery, and re-instrumentation failure were assessed. Data were collected on back pain, neurological deterioration, ambulatory status, and management for patients with instrumentation failure, and we documented radiological bone fusion and re-instrumentation failure in cases followed up for > 2 years after revision surgery. Results: Of the 61 patients, 26 (42.6%) experienced instrumentation failure at an average of 32 (range, 11-92) months after TES. Of these, 23 underwent revision surgery. The average operation time and intraoperative blood loss were 204 min and 97 ml, respectively. Including the six patients who were unable to walk after instrumentation failure, all patients were able to walk after revision surgery. Perioperative complications of reoperation were surgical site infection (n = 2) and delayed wound healing (n = 1). At the final follow-up, bone fusion was observed in all patients. No re-instrumentation failure was recorded. Conclusion: Bone fusion was achieved by revision surgery using the posterior approach alone.

引用

页数：8

共 25 条

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