Improving Safety and Reducing Complications in Spinal Tumors Treatments

A special issue of Current Oncology (ISSN 1718-7729).

Deadline for manuscript submissions: closed (15 November 2021) | Viewed by 6373

Special Issue Editors


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Guest Editor
Department of Spine Surgery, IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy
Interests: spine surgery; spine tumors; spine deformity; spine degenerative; non technical skills; check lists; cervical spine; lumbar spine

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Guest Editor
IRCCS Rizzoli Orthopaedic Institute, 40136 Bologna, Italy
Interests: Surgical complications; Checklists; Spinal bone tumours; Degenerative spine disease; Spine deformity

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Guest Editor
IRCCS Rizzoli Orthopaedic Institute, 40136 Bologna, Italy
Interests: Surgical complications; Checklists; Spinal bone tumours; Degenerative spine disease; Spine deformity

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Guest Editor
University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
Interests: spinal metastases; radiation therapy; bone tumor management

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Guest Editor
Spine Surgery, Orthopedic Department, Sonnenhofspital, 3006 Bern, Switzerland
Interests: Surgical complications; Safety in spinal surgery, Spinal diseases

Special Issue Information

Dear Colleagues,

Surgical treatment is a challenging option both for primary bone tumors of the spine and for spinal metastases.

Primary bone tumors of the spine are rare entities whose treatment algorithms are filled with nuances that are evolving constantly. For most malignant spinal bone tumors, surgery remains the cornerstone of treatment. Respecting oncologic principles has been associated with improved survival and decreased local recurrence in multiple settings. However, even in experienced centers, these surgeries carry a significant risk of adverse events and possible long-term neurologic impairment. The morbidity associated with these procedures and the challenges of local recurrence have encouraged the exploration of alternatives or adjuncts to surgical treatment.

The incidence of metastatic spinal disease is increasing as systemic treatment options are improving and concurrently increasing the life expectancy of patients, and the interventions are becoming increasingly complex. Treatment decisions are also complicated by the increasing development of new surgical techniques, and complications related to surgical treatment are also increasing.

The aim of this Special Issue is to collect and analyze the complications associated with the surgical treatment of spinal bone tumors and to highlight the possible actions and therapeutic alternatives aimed at reducing the impact of complications and increasing patient safety.

Dr. Giovanni Barbanti Brodano
Dr. Giuseppe Tedesco
Dr. Marco Girolami
Prof. Dr. Jorrit Jan Verlaan
Dr. Lorin M. Benneker
Guest Editors

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Keywords

  • primary tumors of the spine
  • spinal metastasis
  • surgical treatment
  • surgical complications
  • patient safety
  • therapeutic choice
  • checklist
  • guideline

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Published Papers (2 papers)

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16 pages, 980 KiB  
Article
Complications and Risk Factors in En Bloc Resection of Spinal Tumors: A Retrospective Analysis on 298 Patients Treated in a Single Institution
by Stefano Bandiera, Luigi Emanuele Noli, Cristiana Griffoni, Giovanni Tosini, Elisa Carretta, Stefano Pasini, Eleonora Pesce, Alfio Damiano Ruinato, Giovanni Barbanti Brodano, Giuseppe Tedesco, Marco Girolami, Silvia Terzi, Riccardo Ghermandi, Gisberto Evangelisti, Valerio Pipola and Alessandro Gasbarrini
Curr. Oncol. 2022, 29(10), 7842-7857; https://doi.org/10.3390/curroncol29100620 - 17 Oct 2022
Cited by 8 | Viewed by 2715
Abstract
En bloc resection consists in the surgical removal of a vertebral tumor in a single piece with a sufficient margin, to improve survival and reduce recurrence rate. This procedure is technically demanding and correlates with a high complication rate. The purpose of this [...] Read more.
En bloc resection consists in the surgical removal of a vertebral tumor in a single piece with a sufficient margin, to improve survival and reduce recurrence rate. This procedure is technically demanding and correlates with a high complication rate. The purpose of this study is to investigate the risk factors for complications in en bloc resection and evaluate if benefits overcome the risks in term of overall survival. We retrospectively analyzed prospectively collected data of patients treated with en bloc resection between 1980 and 2021. Complications were classified according to SAVES-V2. Overall Survival was estimated using Kaplan-Meier method. A total of 149 patients out of 298 (50%) suffered from at least one complication. Moreover, 220 adverse events were collected (67 intraoperative, 82 early post-operative, 71 late post-operative), 54% of these were classified as grade 3 (in a severity scale from 1 to 6). Ten years overall survival was 67% (95% CI 59–74). The occurrence of relapses was associated to an increased risk of mortality with OR 3.4 (95% CI 2.1–5.5), while complications did not affect the overall survival. Despite a high complication rate, en bloc resection allows for a better control of disease and should be performed in selected patients by specialized surgeons. Full article
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13 pages, 781 KiB  
Review
Complication Avoidance in Surgical Management of Vertebral Column Tumors
by Joshua Feler, Felicia Sun, Ankush Bajaj, Matthew Hagan, Samika Kanekar, Patricia Leigh Zadnik Sullivan, Jared S. Fridley and Ziya L. Gokaslan
Curr. Oncol. 2022, 29(3), 1442-1454; https://doi.org/10.3390/curroncol29030121 - 25 Feb 2022
Cited by 2 | Viewed by 2791
Abstract
The surgical management of spinal tumors has grown increasingly complex as treatment algorithms for both primary bone tumors of the spine and metastatic spinal disease have evolved in response to novel surgical techniques, rising complication rates, and additional data concerning adjunct therapies. In [...] Read more.
The surgical management of spinal tumors has grown increasingly complex as treatment algorithms for both primary bone tumors of the spine and metastatic spinal disease have evolved in response to novel surgical techniques, rising complication rates, and additional data concerning adjunct therapies. In this review, we discuss actionable interventions for improved patient safety in the operative care for spinal tumors. Strategies for complication avoidance in the preoperative, intraoperative, and postoperative settings are discussed for approach-related morbidities, intraoperative hemorrhage, wound healing complications, cerebrospinal fluid (CSF) leak, thromboembolism, and failure of instrumentation and fusion. These strategies center on themes such as pre-operative imaging review and medical optimization, surgical dissection informed by meticulous attention to anatomic boundaries, and fastidious wound closure followed by thorough post-operative care. Full article
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