Department of Orthopaedics and Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, Haidian District, 49 North Garden Rd, Beijing, 100191, China.
Department of Orthopedics, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China.
World J Surg Oncol. 2024 Oct 23;22(1):279. doi: 10.1186/s12957-024-03564-6.
Retrospective cohort study.
To explore the complications and risk factors for total resection (TR) of primary thoracic and lumbar spinal tumors over the past decade at our institution.
Patients meeting inclusion criteria (primary spinal tumors, thoracic or lumbar location, TR at our center) were included. Demographic characteristics, surgical data, perioperative complications and management results were reviewed. Patients were stratified by tumor site, the number of excised segments, and recurrence status to elucidate distinctive characteristics.
The cohort comprised 103 patients, with a mean age of 35.8 years. On average, 1.83 vertebral segments were resected per patient. Perioperative complications were substantial, totaling 166 events, with 71 classified as major and 95 as minor, yielding an average of 1.61 complications per patient. No perioperative deaths occurred, but 79 patients (76.7%) experienced at least one complication. Multiple vertebral sections correlated with a higher complication rate (P = 0.031), and lumbar surgeries exhibited elevated risks of large vascular injury (P = 0.001), neurological deterioration, and cerebrospinal fluid leakage compared to thoracic cases. Conversely, thoracic spinal procedures showed a higher rate of pleural effusion (P = 0.004). Binary logistics stepwise regression identified multi-segmental resection as the independent risk factor for major perioperative complications.
TR of primary spinal tumors is associated with a high perioperative complication rate, although most events have a favorable prognosis. Complication characteristics vary based on the surgical site, number of excised segments, and surgical history. A nuanced preoperative evaluating approach considering patient age, surgical segments, and extent of resection is crucial.
回顾性队列研究。
探讨过去十年我院原发性胸腰椎脊柱肿瘤全切除（TR）的并发症及危险因素。
纳入符合纳入标准的患者（原发性脊柱肿瘤，胸腰椎部位，我院行 TR）。回顾性分析患者的人口统计学特征、手术资料、围手术期并发症及处理结果。根据肿瘤部位、切除节段数和复发情况对患者进行分层，以阐明其独特特征。
该队列纳入 103 例患者，平均年龄为 35.8 岁。每位患者平均切除 1.83 个椎体节段。围手术期并发症发生率较高，总计 166 例，其中 71 例为重大并发症，95 例为小并发症，平均每位患者发生 1.61 例并发症。无围手术期死亡，但 79 例（76.7%）患者至少发生 1 种并发症。多节段切除与较高的并发症发生率相关（P=0.031），与胸段手术相比，腰椎手术发生大血管损伤的风险较高（P=0.001）、神经功能恶化和脑脊液漏的风险较高。相反，胸段脊柱手术的胸腔积液发生率较高（P=0.004）。二元逻辑逐步回归分析确定多节段切除是重大围手术期并发症的独立危险因素。
TR 原发性脊柱肿瘤的围手术期并发症发生率较高，但大多数并发症预后良好。并发症的特征因手术部位、切除节段数和手术史而异。术前评估方法需要综合考虑患者年龄、手术节段和切除范围，细致入微。
