Comparison of the effectiveness of endoscopic and open transthoracic removal of tumors of the thoracic vertebrae
DOI:
https://doi.org/10.25305/unj.204079Keywords:
tumors of vertebral bodies, endoscopic removal of tumors, thoracic spineAbstract
The aim of the study was to compare and evaluate the effectiveness of endoscopic and open transthoracic removal of tumors of the thoracic vertebrae.
Materials and methods. A one-center retrospective cohort study was conducted. We compared the data of two groups each consisted of 30 patients with tumors of the thoracic spine. In the first group, open transthoracic removals of tumors of the thoracic vertebrae were performed, in the second group exclusively endoscopic.
The criteria for inclusion of patients were as follows: 1. Patients of any sex and age who underwent inpatient treatment at the State Institution “Romodanov Neurosurgery Institute of NAMSU” in the period from 2010 to 2020; 2. The diagnosis was verified histologically and/or by neuroimaging technology; 3. The primary localization of the tumor is in the thoracic spine.
Results. The endoscopic interventions were associated with statistically significantly (P < 0.05) 1) longer all time of operation; 2) less blood loss; 3) longer implant placement time; 4) less frequency of dural sac visualization.
Immediately after surgery, the mean score on the McCormick scale in the group of direct surgery was 3.2, in the group of endoscopic 3.3. The difference was not statistically significant. Pain syndrome on a Visual Analogue Scale was 4.2 points in the first group, in the second — 2.5. The difference was not statistically significant.
In the group of endoscopic interventions, the frequency of local recurrences is significantly higher, out of 22 patients available for evaluation, 11 (50 %) individuals have a local recurrence of the tumor. Compared with open interventions out of 21 available for assessment, recurrences were found only in 3 patients, which is 14.2 %. The difference in the frequency of redistribution is statistically significant (P < 0.05). We attribute this to the fact that endoscopic interventions reduce the radical removal of tumors.
Conclusions. At endoscopic interventions, it is statistically significantly 1) longer all time of operation; 2) less blood loss; 3) longer implant placement time; 4) less frequency of the dural sac visualization.
References
1. Hasan S, Härtl R, Hofstetter CP. The benefit zone of full-endoscopic spine surgery. J Spine Surg. 2019 Jun;5(Suppl 1):S41-S56. [CrossRef] [PubMed] [PubMed Central]
2. Puvanesarajah V, Lina IA, Liauw JA, Lo SF, Elder BD, Wolinsky JP, Bydon A, Sciubba DM, Gokaslan ZL, Witham TF. Systematic Approach for Anterior Corpectomy through a Transthoracic Exposure. Turk Neurosurg. 2016;26(4):646-52. [CrossRef] [PubMed]
3. Li C, Ye Y, Gu Y, Dong J. Minimally invasive resection of extradural dumbbell tumors of thoracic spine: surgical techniques and literature review. Eur Spine J. 2016 Dec;25(12):4108-4115. [CrossRef] [PubMed]
4. Ziu M, Traylor JI, Paxman J, Gorrebeeck A, Fortes DL. Utilizing Stereotactic Spine Navigation for Posterior Partial Vertebrectomy in an En Bloc Resection of a Superior Pulmonary Sulcus Tumor Invading the Thoracic Vertebrae: A Technical Note. Cureus. 2018 Sep 14;10(9):e3303. [CrossRef] [PubMed] [PubMed Central]
5. Trobisch PD, Verma K. Vertebral body replacement by posterior approach for metastatic disease in the thoracic spine--modified technique using an expandable cage. Oper Orthop Traumatol. 2015 Jun;27(3):270-80. [CrossRef] [PubMed]
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Copyright (c) 2020 Ievgenii I. Slynko, Yuriy V. Derkach
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