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Journal of Craniovertebral Junction and Spine
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REVIEW ARTICLE
Year : 2021  |  Volume : 12  |  Issue : 2  |  Page : 107-116

Spondylectomy in the treatment of neoplastic spinal lesions – A retrospective outcome analysis of 582 patients using a patient-level meta-analysis


1 Department of Orthopedic Surgery, Icahn School of Medicine - Mount Sinai Hospital; Department of Neurosurgery, Hofstra School of Medicine, North Shore University Hospital, NY, USA
2 Department of Neurosurgery, University of Louisville, Louisville, KY, USA
3 Department of Orthopedic Surgery, Icahn School of Medicine - Mount Sinai Hospital, NY, USA
4 Department of Pathology and Laboratory Medicine, Zucker School of Medicine at Hofstra Northwell, NY, USA
5 Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
6 Department of Neurosurgery, Cantonal Hospital of Lucerne, Lucerne, Switzerland
7 Department of Medical Oncology, Cantonal Hospital of Lucerne, Lucerne, Switzerland

Correspondence Address:
Alexander Spiessberger
Department of Neurosurgery, North Shore University Hospital, 300 Community Drive, Manhasset, NY - 11030
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcvjs.jcvjs_211_20

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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.


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