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Repeated total en bloc spondylectomy for spinal metastases at different sites in one patient
Authors
Demura Satoru
Kato Satoshi
+6 more
Murakami Hideki
Sugita Shurei
Tanaka Sakae
Tsuchiya Hiroyuki
Yokogawa Noriaki
Yoshioka Katsuhito
Publication date
1 October 2015
Publisher
'Springer Science and Business Media LLC'
Doi
Cite
Abstract
Purpose: Total en bloc spondylectomy (TES) is accompanied by preoperative embolization of segmental arteries, which is limited to three consecutive levels to avoid the risk of spinal cord ischemia. We retrospectively examined the efficacy and safety of repeated TES with embolization of more than three levels of segmental arteries. Methods: Seven patients underwent TES twice for spinal metastases at different levels. Every patient underwent embolization of the bilateral segmental arteries before each surgery. We assessed the total number of segmental arteries embolized, the existence of Adamkiewicz arteries during the embolization procedure, intraoperative blood loss, and the motor function of the lower limbs, using the American Spinal Injury Association (ASIA) motor score. Results: No patient experienced any motor deficit after embolization. During the embolization procedure, an Adamkiewicz artery was depicted in five patients, which precluded embolization at that level. The median number of segmental arteries embolized in total was 9 (9–11). Intraoperative blood loss (median, IQR) was 480 (420–630) ml during the first surgery and 520 (280–600) ml during the second surgery. The ASIA motor scores (median, IQR) were as follows; 100 (98–100) (first admission), 100 (100–100) (first discharge), 100 (98–100) (second admission), and 97 (94–100) (second discharge). No patients had developed statistically significant neurological deterioration, and there had been no local recurrence after a median follow-up of 17.8 months (range 1–51 months). Conclusion: Repeated TES procedures can be performed safely even if more than three levels of segmental arteries are embolized. © 2015, Springer-Verlag Berlin Heidelberg.Embargo Period 12 month
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Kanazawa University Repository for Academic Resources
See this paper in CORE
Go to the repository landing page
Download from data provider
oai:kanazawa-u.repo.nii.ac.jp:...
Last time updated on 06/05/2019