Yodsuwan Danaya, Paholpak Permsak, Wisanuyotin Taweechok, Sirichativapee Winai, Sirichativapee Wilasinee, Kosuwon Weerachai, Morimoto Tadatsugu, Kasai Yuichi, Murakami Hideki
Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
Orthopaedics, Chumpae Hospital, Khon Kaen, Thailand.
J Orthop Surg Res. 2025 Apr 15;20(1):377. doi: 10.1186/s13018-025-05797-x.
Total en bloc spondylectomy (TES) was considered aggressive spinal surgery aim to achieved marginal and wide surgical margin in spinal tumor treatment. However, there was limited comparison information between TES and other palliative spinal surgery treatments. This study aimed to report the comparison between TES and Palliative Spinal Surgery (PSS) in terms of clinical and oncologic outcomes.
A retrospective cohort study was conducted. The medical records of Spinal Metastasis (SM) treated by a single surgeon were reviewed between January 2014 and December 2020. The propensity score matching was calculated. survivorship, local recurrence, surgical complications, operative blood loss, and time between TES and PSS were reviewed and analyzed.
A total of 44 patients with a mean age of 56 were included. Twenty-two TES and 22 PSS patients were recruited into the study-no significant difference in demographics data. The TES showed significantly better survival at 6 (p = 0.010) and 12 months (p = 0.020). The local recurrence in the TES group was 4.6% (1 of 22). However, TES showed significantly longer operative time (6 h (5.5-6.5) and 3 h (2.0-3.5), p-value < 0.001) and more intraoperative blood loss (1150 mL (1000-1800) and 575 mL (350-800), p-value = 0.0002).
TES showed better survivorship after 6 and 12 months than PSS. The TES also achieved favorable local control of tumors after surgery. Further randomized control of more patients should be conducted to clarify the benefits of TES vis-à-vis metastasis.
整块全脊椎切除术（TES）被认为是一种积极的脊柱手术，旨在在脊柱肿瘤治疗中实现边缘和广泛的手术切缘。然而，TES与其他姑息性脊柱手术治疗之间的比较信息有限。本研究旨在报告TES与姑息性脊柱手术（PSS）在临床和肿瘤学结果方面的比较。
进行了一项回顾性队列研究。回顾了2014年1月至2020年12月期间由单一外科医生治疗的脊柱转移瘤（SM）的病历。计算了倾向得分匹配。对生存率、局部复发、手术并发症、术中失血量以及TES和PSS之间的时间进行了回顾和分析。
共纳入44例平均年龄为56岁的患者。22例接受TES的患者和22例接受PSS的患者被纳入研究——人口统计学数据无显著差异。TES在6个月（p = 0.010）和12个月（p = 0.020）时的生存率显著更高。TES组的局部复发率为4.6%（22例中的1例）。然而，TES的手术时间显著更长（6小时（5.5 - 6.5）和3小时（2.0 - 3.5），p值<0.001），术中失血量更多（1150毫升（1000 - 1800）和575毫升（350 - 800），p值 = 0.0002）。
TES在6个月和12个月后的生存率优于PSS。TES术后也实现了良好的肿瘤局部控制。应进行更多患者的进一步随机对照研究，以阐明TES相对于转移瘤的益处。
