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Thoracolumbar corpectomy/spondylectomy for spinal metastasis: a pooled analysis comparing the outcome of seven different surgical approaches

  • Alexander SpiessbergerEmail author
  • Varun Arvind
  • Basil Gruter
  • Samuel K. Cho
Review Article
  • 106 Downloads

Abstract

Objective

To compare surgical outcomes between seven different approaches for thoracolumbar corpectomy/spondylectomy in the setting of spinal metastasis.

Methods

A systematic review of literature was performed including articles on corpectomy for thoracolumbar spinal metastasis. Data were extracted and sorted by surgical approach: en bloc spondylectomy (group 1), transpedicular (group 2), costotransversectomy (group 3), mini-open retropleural/retroperitoneal (group 4a), lateral extracavitary approach (group 4b), open transthoracic/transretroperitoneal (group 5), and thoracoscopic (group 6). Comparison of demographics, blood loss, directly procedure related complications, operating time, and postoperative improvement of pain.

Results

A total of 63 articles were included comprising data of 774 patients with various primary tumor entities. Mean age was 51.8 years, 54% of patients were female, on average 1.46 levels were treated per patient, and mean follow-up was 1.59 years. The following statistically significant findings were observed: Blood loss was lowest for the mini-open retropleural/retroperitoneal (917 ml), thoracoscopic (1107 ml) and transthoracic approach (1172 ml) versus the posterior approach groups (1633–2261 ml); directly procedure related complications were lowest for mini-open retropleural/retroperitoneal and thoracoscopic approach (0% each) versus 7–15% in the other groups; operating time was lowest in mini-open retropleural/retroperitoneal approach (184 min) versus 300–588 min in the other groups.

Conclusion

Less invasive approaches (mini-open retropleural/retroperitoneal and thoracoscopic) not only had superior outcome in terms of blood loss and operating time, but also were shown to be safe techniques in cancer patients with low rates of procedure-related complications.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

Keywords

Spinal metastasis Anterior decompression Corpectomy Spondylectomy Mini-open 

Notes

Funding

No funding has been received for this study.

Compliance with ethical standards

Conflict of interest

The authors to have no conflict of interest.

Supplementary material

586_2019_6179_MOESM1_ESM.pptx (6.2 mb)
Supplementary material 1 (PPTX 6309 kb)
586_2019_6179_MOESM2_ESM.docx (37 kb)
Supplementary material 2 (DOCX 36 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopedic Surgery, Icahn School of MedicineMount Sinai HospitalNew YorkUSA
  2. 2.Department of NeurosurgeryKantonsspital AarauAarauSwitzerland

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