TY - JOUR
T1 - En bloc resection in patients younger than 16 years affected by primary spine tumors
T2 - indications, results and complications in a series of 22 patients
AU - Luzzati, Alessandro
AU - Scotto, Gennaro
AU - Cannavò, Luca
AU - Scotto di Uccio, Alessandra
AU - Orlando, Giuseppe
AU - Petriello, Luisa
AU - Zoccali, Carmine
N1 - Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/12
Y1 - 2020/12
N2 - Purpose: Review a series of 22 patients below the age of 16 affected by primary bone tumors of the spine who underwent en bloc resection, and describe the clinical presentation, tumor characteristics, results and complications associated with the surgical treatment, underlining the specific issues related to a younger age. Methods: We performed a review of all patients < 16 years old affected by primary bone tumors of the spine, surgically treated with en bloc resection from 1996 to 2016. Clinical and radiological characteristics, therapy, complications and survival are reported. Results: Only 12/22 cases had not been previously treated. 22.7% experienced at least one early complication; 18.2% and 4.1% experienced at least 2 and ≥ 3 early complications, respectively; 40.9% experienced at least one late complication, often related to hardware failure (27.3%); 18.2% and 4.5% at least 2 and ≥ 3 late complications. No early nor late complications were experienced in 12 out of 22 patients (54.54%). The overall survival and the local recurrence-free survival at 5 years were, respectively, 79.5% and 74.8%; considering only the patients with high-grade tumors, they were 70.9% and 65.5%, respectively. At 77.3 months of median follow-up, 17 patients are still alive, 16 of whom without any evidence of disease and 1 with evidence of local and systemic disease; four patients died with evidence of local disease and one with distant metastases but no local recurrence. Conclusions: Young people with primary malignant or locally aggressive bone tumors of the spine should be treated in specialized centers, and wide surgery should be performed. The most frequent problems are related to reconstruction in a growing spine and subsequent hardware failure that make later surgeries necessary. Graphic abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].
AB - Purpose: Review a series of 22 patients below the age of 16 affected by primary bone tumors of the spine who underwent en bloc resection, and describe the clinical presentation, tumor characteristics, results and complications associated with the surgical treatment, underlining the specific issues related to a younger age. Methods: We performed a review of all patients < 16 years old affected by primary bone tumors of the spine, surgically treated with en bloc resection from 1996 to 2016. Clinical and radiological characteristics, therapy, complications and survival are reported. Results: Only 12/22 cases had not been previously treated. 22.7% experienced at least one early complication; 18.2% and 4.1% experienced at least 2 and ≥ 3 early complications, respectively; 40.9% experienced at least one late complication, often related to hardware failure (27.3%); 18.2% and 4.5% at least 2 and ≥ 3 late complications. No early nor late complications were experienced in 12 out of 22 patients (54.54%). The overall survival and the local recurrence-free survival at 5 years were, respectively, 79.5% and 74.8%; considering only the patients with high-grade tumors, they were 70.9% and 65.5%, respectively. At 77.3 months of median follow-up, 17 patients are still alive, 16 of whom without any evidence of disease and 1 with evidence of local and systemic disease; four patients died with evidence of local disease and one with distant metastases but no local recurrence. Conclusions: Young people with primary malignant or locally aggressive bone tumors of the spine should be treated in specialized centers, and wide surgery should be performed. The most frequent problems are related to reconstruction in a growing spine and subsequent hardware failure that make later surgeries necessary. Graphic abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].
KW - En bloc spondylectomy
KW - Growing spine
KW - Hardware failure
KW - Pediatric spinal bone tumors
KW - Pediatric spine
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U2 - 10.1007/s00586-020-06387-7
DO - 10.1007/s00586-020-06387-7
M3 - Article
C2 - 32239356
AN - SCOPUS:85082809148
VL - 29
SP - 3135
EP - 3147
JO - European Spine Journal
JF - European Spine Journal
SN - 0940-6719
IS - 12
ER -