Outcomes of Posterior Thoracic Corpectomies for Metastatic Spine Tumors: An Analysis of 90 Patients

• Published in: World neurosurgery Vol. 123; pp. e371 - e378
• Main Authors: Zhou, Rong Ping, Mummaneni, Praveen V., Chen, Kai-Yuan, Lau, Darryl, Cao, Kai, Amara, Dominic, Zhang, Can, Dhall, Sanjay, Chou, Dean
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-03-2019
• Subjects: Complications; Costotransversectomy; Metastatic thoracic tumor; Posterior approach; Transpedicular corpectomy; Metastatic thoracic tumor; ASIA; Complications; Costotransversectomy; Transpedicular corpectomy; VAS; MTT; Posterior approach
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2018.11.172

To retrospectively analyze the outcomes and complications of patients with metastatic thoracic spinal tumors (MTTs) who underwent posterior corpectomies.
Ninety patients with MTTs who underwent posterior corpectomies were retrospectively analyzed. Characteristics evaluated included number of MTTs per year, location, involved vertebrae numbers, sex, histology, pre- and postoperative American Spinal Injury Association (ASIA) grade, visual analog scale (VAS) pain scores, operative time, blood loss, and length of hospital stay.
The average follow-up was 20.8 ± 27.9 months (range, 0.5–139.4 months). Of the patients, 76.67% had a single metastasis and 23.33% had multiple metastases. For histology, 16.67% were breast, 15.56% were lung, 12.22% were prostate, and 12.22% were renal cell carcinoma. Of the patients with paraplegia and paraparesis, 74% improved. One patient improved from ASIA grade A to D, 3 patients improved from grade B to C, 8 patients improved from grade C to D or E, and 25 patients improved from grade D to E. Three patients (6%) with ASIA grade A and 1 patient (2%) with ASIA grade B had no improvement. One patient with ASIA grade C and 8 patients (16%) with grade D had no improvement. After surgery, VAS pain scores decreased from 8.45 ± 1.57 to 1.211 ± 1.81. In terms of complications, 2 patients (2.22%) had deep vein thrombosis and 1 patient had pulmonary embolism (1.11%). Other complications included wound infection (4.44%), cerebrospinal fluid leak (4.44%), pleural effusion (3.33%), wound dehiscence (2.22%), cellulitis (1.11%), epidural hematoma (1.11%), and pneumothorax (1.11%). Of the patients, 2.22% had implant failure and pseudoarthrosis, with 1 patient needing revision surgery. One patient (1.11%) had tumor recurrence.
Our results suggest that posterior thoracic corpectomies for MTTs have a reasonable complication rate with favorable outcomes.