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Conventional Radiotherapy Timing and Wound Complication Avoidance After Surgery for Metastatic Spine Disease. A LatAm Modified Delphi Study

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dc.contributor.authorLandriel, Federico
dc.contributor.authorWhite, Kevin
dc.contributor.authorPadilla Lichtenberger, Fernando
dc.contributor.authorGuiroy, Alfredo
dc.contributor.authorTeles, Alisson
dc.contributor.authorLaos Plasier, Eduardo
dc.contributor.authorBuzetti Milano, Jerônimo
dc.contributor.authorRisso, Marcelo
dc.contributor.authorAstur, Nelson
dc.contributor.authorGonzález, Oscar
dc.contributor.authorYurac, Ratko
dc.contributor.authorPáez, Rodolfo
dc.contributor.authorTeixeira, William
dc.contributor.authorToscano, Maximiliano
dc.contributor.authorHem, Santiago
dc.date.accessioned2026-09-23T20:54:15Z
dc.date.available2026-09-23T20:54:15Z
dc.date.issued2025
dc.description.abstractBackground Combining surgery and radiotherapy is the gold standard in treating spinal metastasis when spinal stabilization or surgical decompression is required. Determining the optimal timing for radiotherapy postsurgery is crucial to balance treatment efficacy minimizing wound complications. The study aimed to identify consensus and nonconsensus areas among Latin American spinal surgeons regarding the use, timing, risks, and surgical approach to conventional external beam radiotherapy (cEBRT) following spinal surgery for metastases, specifically focusing on the risk of radiotherapy-related wound complications. Methods A modified Delphi survey was conducted. The expert panel included active members of AOSpine Latin America with extensive experience in vertebral metastasis surgery. The surveys include 37 statements covering areas of interest. Inter-expert consensus was considered weak (70-79.9%), moderate (80-89.9%), and strong (≥90%). Results At least 70% consensus was reached on 32 of the 37 statements (86.5%). This included strong consensus on 10 statements, moderate on 13, and weaker on nine. There was high consensus on sutures and lower consensus on risk factors for cEBRT delay. Experts reached strong agreement on the importance of poor nutrition as a risk factor for cEBRT-related wound complications. Perception of wound risk was greater with a posterior midline approach compared to other approaches, and the highest perceived complication risks were for junctional locations and sacral spine. Conclusions We report strong agreements among the experts on important issues such as waiting times and risk factors for cEBRT. The findings underscore the significance of considering factors such as, spinal levels, surgical approaches, and sutures when making clinical decisions.
dc.description.versionVersión publicada
dc.format.extent8 p.
dc.identifier.citationFederico Landriel, Kevin White, Fernando Padilla Lichtenberger, Alfredo Guiroy, Alisson Teles, Eduardo Laos Plasier, Jerônimo Buzetti Milano, Marcelo Risso, Nelson Astur, Oscar González, Ratko Yurac, Rodolfo Páez, William Teixeira, Maximiliano Toscano, Santiago Hem, Conventional Radiotherapy Timing and Wound Complication Avoidance After Surgery for Metastatic Spine Disease. A LatAm Modified Delphi Study, World Neurosurgery, Volume 195, 2025, 123575, ISSN 1878-8750, https://doi.org/10.1016/j.wneu.2024.123575
dc.identifier.doihttps://doi.org/10.1016/j.wneu.2024.123575
dc.identifier.urihttps://hdl.handle.net/11447/11176
dc.language.isoen
dc.rightsAtribución-NoComercial-CompartirIgual 3.0 Chile (CC BY-NC-SA 3.0 CL)
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/cl/
dc.subjectMetastatic spine Delphi study
dc.subjectRadiotherapy timing
dc.subjectWound complication
dc.subjectWound dehiscence
dc.titleConventional Radiotherapy Timing and Wound Complication Avoidance After Surgery for Metastatic Spine Disease. A LatAm Modified Delphi Study
dc.typeArticle
dcterms.accessRightsAcceso abierto
dcterms.sourceWorld Neurosurgery
dspace.entity.typePublication

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