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En bloc resection of huge primary tumors with epidural involvement in the mobile spine using the “rotation–reversion” technique: Feasibility, safety, and clinical outcome of 11 cases

BACKGROUND: En bloc resection of spinal tumors provides better local control and survival outcomes than intralesional resection. Safe margins during en bloc resection of primary spinal tumors with epidural involvement are required for improved outcomes. The present study describes a “rotation–revers...

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Autores principales: Lu, Ming, Zhou, Zhongxin, Chen, Wei, Lei, Zixiong, Dai, Shuangwu, Hou, Changhe, Du, Shaohua, Jin, Qinglin, Jin, Dadi, Boriani, Stefano, Li, Haomiao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9751655/
https://www.ncbi.nlm.nih.gov/pubmed/36530980
http://dx.doi.org/10.3389/fonc.2022.1031708
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author Lu, Ming
Zhou, Zhongxin
Chen, Wei
Lei, Zixiong
Dai, Shuangwu
Hou, Changhe
Du, Shaohua
Jin, Qinglin
Jin, Dadi
Boriani, Stefano
Li, Haomiao
author_facet Lu, Ming
Zhou, Zhongxin
Chen, Wei
Lei, Zixiong
Dai, Shuangwu
Hou, Changhe
Du, Shaohua
Jin, Qinglin
Jin, Dadi
Boriani, Stefano
Li, Haomiao
author_sort Lu, Ming
collection PubMed
description BACKGROUND: En bloc resection of spinal tumors provides better local control and survival outcomes than intralesional resection. Safe margins during en bloc resection of primary spinal tumors with epidural involvement are required for improved outcomes. The present study describes a “rotation–reversion” technique that has been used for en bloc resection of huge primary tumors in the mobile spine with epidural involvement and reported the clinical outcomes in these patients. METHODS: All patients with primary spinal tumors who were treated with the rotation–reversion technique at our institution between 2015 and 2021 were evaluated retrospectively. Of the patients identified, those with both huge extraosseous soft-tissue masses and epidural involvement were selected for a case review. Clinical and radiological characteristics, pathologic findings, operative procedures, complications, and oncological and functional outcomes of these patients were reviewed. RESULTS: Of the 86 patients identified with primary spinal tumors who underwent en bloc resection using the rotation–reversion technique between 2015 and 2021, 11 had huge extraosseous soft-tissue masses with epidural involvement in the mobile spine. The average maximum size of these 11 tumors was 8.1 × 7.5 × 9.7 cm. Median follow-up time was 28.1 months, mean operation time was 849.1 min (range 465–1,340 min), and mean blood loss was 6,972.7 ml (range 2,500–17,700 ml), with 10 (91%) of the 11 patients experiencing perioperative complications. The negative margin rate was 91%, with only one patient (9%) experiencing local recurrence. Ten patients were able to walk normally or with a crutch at the last follow-up, whereas one was completely paralyzed preoperatively. CONCLUSION: The rotation–reversion technique is an effective procedure for the en bloc resection of huge primary spinal tumors, with the extension of invasion in selected patients including not only the vertebral body but also the pedicle and part of the posterior arch.
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spelling pubmed-97516552022-12-16 En bloc resection of huge primary tumors with epidural involvement in the mobile spine using the “rotation–reversion” technique: Feasibility, safety, and clinical outcome of 11 cases Lu, Ming Zhou, Zhongxin Chen, Wei Lei, Zixiong Dai, Shuangwu Hou, Changhe Du, Shaohua Jin, Qinglin Jin, Dadi Boriani, Stefano Li, Haomiao Front Oncol Oncology BACKGROUND: En bloc resection of spinal tumors provides better local control and survival outcomes than intralesional resection. Safe margins during en bloc resection of primary spinal tumors with epidural involvement are required for improved outcomes. The present study describes a “rotation–reversion” technique that has been used for en bloc resection of huge primary tumors in the mobile spine with epidural involvement and reported the clinical outcomes in these patients. METHODS: All patients with primary spinal tumors who were treated with the rotation–reversion technique at our institution between 2015 and 2021 were evaluated retrospectively. Of the patients identified, those with both huge extraosseous soft-tissue masses and epidural involvement were selected for a case review. Clinical and radiological characteristics, pathologic findings, operative procedures, complications, and oncological and functional outcomes of these patients were reviewed. RESULTS: Of the 86 patients identified with primary spinal tumors who underwent en bloc resection using the rotation–reversion technique between 2015 and 2021, 11 had huge extraosseous soft-tissue masses with epidural involvement in the mobile spine. The average maximum size of these 11 tumors was 8.1 × 7.5 × 9.7 cm. Median follow-up time was 28.1 months, mean operation time was 849.1 min (range 465–1,340 min), and mean blood loss was 6,972.7 ml (range 2,500–17,700 ml), with 10 (91%) of the 11 patients experiencing perioperative complications. The negative margin rate was 91%, with only one patient (9%) experiencing local recurrence. Ten patients were able to walk normally or with a crutch at the last follow-up, whereas one was completely paralyzed preoperatively. CONCLUSION: The rotation–reversion technique is an effective procedure for the en bloc resection of huge primary spinal tumors, with the extension of invasion in selected patients including not only the vertebral body but also the pedicle and part of the posterior arch. Frontiers Media S.A. 2022-12-01 /pmc/articles/PMC9751655/ /pubmed/36530980 http://dx.doi.org/10.3389/fonc.2022.1031708 Text en Copyright © 2022 Lu, Zhou, Chen, Lei, Dai, Hou, Du, Jin, Jin, Boriani and Li https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Lu, Ming
Zhou, Zhongxin
Chen, Wei
Lei, Zixiong
Dai, Shuangwu
Hou, Changhe
Du, Shaohua
Jin, Qinglin
Jin, Dadi
Boriani, Stefano
Li, Haomiao
En bloc resection of huge primary tumors with epidural involvement in the mobile spine using the “rotation–reversion” technique: Feasibility, safety, and clinical outcome of 11 cases
title En bloc resection of huge primary tumors with epidural involvement in the mobile spine using the “rotation–reversion” technique: Feasibility, safety, and clinical outcome of 11 cases
title_full En bloc resection of huge primary tumors with epidural involvement in the mobile spine using the “rotation–reversion” technique: Feasibility, safety, and clinical outcome of 11 cases
title_fullStr En bloc resection of huge primary tumors with epidural involvement in the mobile spine using the “rotation–reversion” technique: Feasibility, safety, and clinical outcome of 11 cases
title_full_unstemmed En bloc resection of huge primary tumors with epidural involvement in the mobile spine using the “rotation–reversion” technique: Feasibility, safety, and clinical outcome of 11 cases
title_short En bloc resection of huge primary tumors with epidural involvement in the mobile spine using the “rotation–reversion” technique: Feasibility, safety, and clinical outcome of 11 cases
title_sort en bloc resection of huge primary tumors with epidural involvement in the mobile spine using the “rotation–reversion” technique: feasibility, safety, and clinical outcome of 11 cases
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9751655/
https://www.ncbi.nlm.nih.gov/pubmed/36530980
http://dx.doi.org/10.3389/fonc.2022.1031708
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