Pennington Zach, Schwab Joseph H, Lo Sheng-Fu Larry, Goodwin C Rory, Goodwin Matthew L, Colman Matthew, Charest-Morin Raphaële, Dea Nicolas, Lubelski Daniel, Ozturk Ali, Buchowski Jacob M, Gibbs Wende, Hsu Wesley, Krishnaney Ajit, Laufer Ilya, Macki Mohamed, Mesfin Addisu, Shankar Ganesh, Tobert Dan, Shin John, Platt Andrew, Sciubba Daniel M
Department of Neurosurgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States.
Department of Orthopedics, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, United States.
N Am Spine Soc J. 2025 Aug 5;23:100779. doi: 10.1016/j.xnsj.2025.100779. eCollection 2025 Sep.
With advances in surgical techniques, radiation, and systemic therapy, prognoses and quality of life have improved amongst patients with primary and metastatic vertebral column tumors. Sagittal deformity is known to have an adverse impact on patient quality of life but has been largely ignored in this study population.
A comprehensive literature review was conducted, focusing on articles germane to the study of spinal deformity in the context of oncologic disease. Articles included those focusing on bone health, the association of spinal deformity with oncologic spine disease, and both pelvic and anterior column reconstruction in patients treated for primary tumors.
Little to date has focused specifically on the management of spinal deformity in the context of spinal tumors. However, it is known that tumor involvement of the vertebral column is associated with poorer screw purchase, which can be further worsened by radiotherapy. Instrumentation techniques that seek to address underlying deformity must also balance the need for radiographic follow-up, which is improved with novel carbon fiber-reinforced polyetheretherketone implants, and the need for intraoperative contouring. Last, residual deformity is associated with poorer patient reported outcomes and increased mechanical complications in adult spinal deformity, but better study within the spinal oncology population is merited.
The potential negative impact of spinal deformity on patient quality of life in the spinal oncology population is now better appreciated amongst spinal oncologists, but studies have been limited to date. Further investigation is merited as survival outcomes continue to improve.
随着手术技术、放疗和全身治疗的进步，原发性和转移性脊柱肿瘤患者的预后和生活质量有所改善。矢状面畸形已知会对患者生活质量产生不利影响，但在该研究人群中很大程度上被忽视了。
进行了全面的文献综述，重点关注与肿瘤疾病背景下脊柱畸形研究相关的文章。这些文章包括关注骨骼健康、脊柱畸形与肿瘤性脊柱疾病的关联以及原发性肿瘤患者的骨盆和前柱重建的文章。
迄今为止，很少有研究专门关注脊柱肿瘤背景下脊柱畸形的管理。然而，已知脊柱肿瘤累及会导致螺钉固定效果较差，放疗会进一步加重这种情况。旨在解决潜在畸形的内固定技术还必须平衡影像学随访的需求（新型碳纤维增强聚醚醚酮植入物可改善这一点）和术中塑形的需求。最后，残留畸形与成人脊柱畸形患者报告的较差预后及机械并发症增加有关，但在脊柱肿瘤人群中需要进行更好的研究。
脊柱肿瘤人群中脊柱畸形对患者生活质量的潜在负面影响现在在脊柱肿瘤学家中得到了更好的认识，但迄今为止研究有限。随着生存结果不断改善，值得进一步研究。
