Low Implant Failure Rate of Percutaneous Fixation for Spinal Metastases: A Multicenter Retrospective Study
Date
2021
Type:
Article
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Abstract
OBJECTIVE: To evaluate incidence and types of implant failure observed in a series of patients with spinal metastases (SM) treated with minimally invasive stabilizationsurgery without fusion.
METHODS: In this multicenter, retrospective, observational study, we reviewed the files of patients >18 years old who underwent surgery for SM using percutaneous spinal stabilization without fusion with a minimum 3-month followup. The following variables were included: demographics,clinical findings, prior radiation history, SM location, epidural spinal cord compression scale, Spinal Instability Neoplastic Scale, neurological examination, and surgeryrelated data. Primary outcome measure was implant failure rate, as observed in patients’ last computed tomography scan. Multivariable analysis was performed to identify baseline factors and factors associated with implant failure.
RESULTS: Analysis included 72 patients. Mean age of patients was 62 years, 39 patients were men, and 75% of patients had an intermediate Spinal Instability Neoplastic
Scale score. Tumor separation surgery was performed in 48.6% of patients. Short instrumentation was indicated in 54.2% of patients. Three patients (4.2%) experienced
implant failure (2 screw loosening, 1 screw cut-out); none of them required revision surgery. In 73.6% of cases, survival was >6 months. No significant predictors of failure were identified in the multivariate analysis.
CONCLUSIONS: A low implant failure rate was observed over the short and medium term, even when short instrumentations without fusion were performed. These
findings suggest that minimally invasive stabilization surgery without fusion may be an effective and safe way to treat complicated SM.
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Citation
Silva A, Yurac R, Guiroy A, Bravo O, Morales Ciancio A, Landriel F, Hem S. Low Implant Failure Rate of Percutaneous Fixation for Spinal Metastases: A Multicenter Retrospective Study. World Neurosurg. 2021 Apr;148:e627-e634. doi: 10.1016/j.wneu.2021.01.047
Keywords
Implant failure, Minimally invasive spine surgery, Percutaneous spinal fixation, Spinal metastases