TY - JOUR
T1 - Influence of a thread wire saw guide and spinal cord protector device in "en bloc" vertebrectomies
AU - Gasbarrini, Alessandro
AU - Simoes, Christiano Esteves
AU - Amendola, Luca
AU - Bandiera, Stefano
AU - Bròdano, Giovanni Barbanti
AU - Cappuccio, Michele
AU - Boriani, Stefano
PY - 2012/4
Y1 - 2012/4
N2 - STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The objective of the study was to describe and compare the surgical outcomes between the use of a new auto static spinal cord and thread wire guiding device and the traditional scalpel technique for en bloc vertebrectomies using only the posterior approach. SUMMARY OF BACKGROUND DATA: As en bloc vertebrectomy has become more accepted as the ideal treatment for selected cases of spine tumors, its high morbidity has to be kept in mind. Uneven cutting surfaces and high risk of spinal cord lesions are among the problems. Although some modifications of the technique and development of new devices to minimize the risks have been reported, there are still some pitfalls associated with them. METHODS: Twenty-five patients, divided into 2 groups, were retrospectively reviewed. Patients in group 1 (G1) were operated using the device, and the patients in group 2 (G2) underwent en bloc vertebrectomy by the traditional scalpel technique. The surgical time, amount of blood loss based on the total volume of blood transfusion during surgery, and the rate of complication were compared. RESULTS: No differences regarding sex, age, and preoperative status occurred. The mean operative time was 294 and 388 minutes and the mean volume of transfused blood was 37 and 53 mL/kg for G1 and G2, respectively. These differences were not statistically significant. CONCLUSIONS: Patient selection and surgical experience are the best outcome predictors. However, methods to reduce the risks of neural lesions, surgical time, and blood loss should always be applied, specially dealing with highly morbid and demanding procedures in the spine.
AB - STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The objective of the study was to describe and compare the surgical outcomes between the use of a new auto static spinal cord and thread wire guiding device and the traditional scalpel technique for en bloc vertebrectomies using only the posterior approach. SUMMARY OF BACKGROUND DATA: As en bloc vertebrectomy has become more accepted as the ideal treatment for selected cases of spine tumors, its high morbidity has to be kept in mind. Uneven cutting surfaces and high risk of spinal cord lesions are among the problems. Although some modifications of the technique and development of new devices to minimize the risks have been reported, there are still some pitfalls associated with them. METHODS: Twenty-five patients, divided into 2 groups, were retrospectively reviewed. Patients in group 1 (G1) were operated using the device, and the patients in group 2 (G2) underwent en bloc vertebrectomy by the traditional scalpel technique. The surgical time, amount of blood loss based on the total volume of blood transfusion during surgery, and the rate of complication were compared. RESULTS: No differences regarding sex, age, and preoperative status occurred. The mean operative time was 294 and 388 minutes and the mean volume of transfused blood was 37 and 53 mL/kg for G1 and G2, respectively. These differences were not statistically significant. CONCLUSIONS: Patient selection and surgical experience are the best outcome predictors. However, methods to reduce the risks of neural lesions, surgical time, and blood loss should always be applied, specially dealing with highly morbid and demanding procedures in the spine.
KW - complication
KW - en bloc resection
KW - morbidity
KW - spine tumors
KW - vertebrectomy
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U2 - 10.1097/BSD.0b013e31823d3699
DO - 10.1097/BSD.0b013e31823d3699
M3 - Article
C2 - 22105102
AN - SCOPUS:84859635123
VL - 25
JO - Journal of Spinal Disorders
JF - Journal of Spinal Disorders
SN - 1536-0652
IS - 2
ER -