Journal Browser Advanced Search Help
Journal Browser Advanced search HELP
J Korean Neurosurg Soc. 2018 May;61(3):415-423. English. Original Article. https://doi.org/10.3340/jkns.2017.0505.002
Park SB , Kim KJ , Han S , Oh S , Kim CH , Chung CK .
Department of Neurosurgery, Seoul National University Boramae Medical Center, Seoul, Korea.
Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Department of Biostatistics, Seoul National University Boramae Medical Center, Seoul, Korea.
Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea. chungc@snu.ac.kr
Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.
Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul, Korea.
Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Korea.
Abstract

Objective

To identify the perioperative factors associated with instrument failure in patients undergoing a partial corpectomy with instrumentation (PCI) for spinal metastasis.

Methods

We assessed the one hundred twenty-four patients with who underwent PCI for a metastatic spine from 1987 to 2011. Outcome measure was the risk factor related to implantation failure. The preoperative factors analyzed were age, sex, ambulation, American Spinal Injury Association grade, bone mineral density, use of steroid, primary tumor site, number of vertebrae with metastasis, extra-bone metastasis, preoperative adjuvant chemotherapy, and preoperative spinal radiotherapy. The intraoperative factors were the number of fixed vertebrae, fixation in osteolytic vertebrae, bone grafting, and type of surgical approach. The postoperative factors included postoperative adjuvant chemotherapy and spinal radiotherapy. This study was supported by the National Research Foundation grant funded by government. There were no study-specific biases related to conflicts of interest.

Results

There were 15 instrumentation failures (15/124, 12.1%). Preoperative ambulatory status and primary tumor site were not significantly related to the development of implant failure. There were no significant associations between insertion of a bone graft into the partial corpectomy site and instrumentation failure. The preoperative and operative factors analyzed were not significantly related to instrumentation failure. In univariable and multivariable analyses, postoperative spinal radiotherapy was the only significant variable related to instrumentation failure (p=0.049 and 0.050, respectively).

Conclusion

When performing PCI in patients with spinal metastasis followed by postoperative spinal radiotherapy, the surgeon may consider the possibility of instrumentation failure and find other strategies for augmentation than the use of a bone graft for fusion.

Copyright © 2019. Korean Association of Medical Journal Editors.