Medium Term Outcomes in Palliative Transpedicular Corpectomy with Cement Based Anterior Vertebral Reconstruction Performed for Patients with Spinal Metastasis

Maroun Rizkallah; Ghassan Boubez; Jesse Shen; Fidaa Alshakfa; Philippe Phan; Van Tri Truong; Duy Phan; Zhi Wang

doi:10.1097/BRS.0000000000005071

Medium Term Outcomes in Palliative Transpedicular Corpectomy with Cement Based Anterior Vertebral Reconstruction Performed for Patients with Spinal Metastasis

Spine (Phila Pa 1976). 2024 Jun 12. doi: 10.1097/BRS.0000000000005071. Online ahead of print.

Authors

Maroun Rizkallah^{1

2}, Ghassan Boubez³, Jesse Shen³, Fidaa Alshakfa³, Philippe Phan⁴, Van Tri Truong⁵, Duy Phan⁵, Zhi Wang³

Affiliations

¹ Department of Orthopedic Surgery, Dr. Georges-L-Dumont University Hospital, Moncton, New-Brunswick, Canada.
² Centre de formation médicale du Nouveau Brunswick, Sherbrook university, Department of surgery, Moncton, New-Brunswick, Canada.
³ Department of Orthopedic Surgery, University of Montreal Health Center, Montreal, Quebec, Canada.
⁴ Division of Orthopedic Surgery, Ottawa Hospital Civic Campus, Ottawa, Ontario, Canada.
⁵ Department of Neurosurgery, Vinmec Central Park International Hospital, Vinmec Healthcare System, Viet Nam.

PMID: 38864462
DOI: 10.1097/BRS.0000000000005071

Abstract

Study design: Retrospective.

Objective: Assess the outcomes of single stage posterior transpedicular corpectomy with cement-based anterior column support for spinal metastasis at longer follow-ups.

Summary of background data: Life expectancy of cancer patients is constantly increasing. Reliable anterior column reconstruction after posterior corpectomy becomes necessary.

Methods: In this retrospective monocentric study, patients who underwent posterior transpedicular corpectomy and cement-based anterior reconstruction, with a minimum 6 months follow-up, were included. Ambulatory status and pain visual analog score(PVAS), complication rates and Local Sagittal Cobb angle (LSA) were evaluated preoperatively, postoperatively and at the latest follow-up.

Results: In total, 253 patients were included, with a mean follow-up of 21 months [6-132] and a median survival of 9 months. Pre-operatively, 202 patients(81%) were ambulant while 47 patients (19%) weren't. At the latest follow-up, 241 patients (95%) were ambulant while 12 patients(5%) weren't (P<0.001). Dorsal/lumbar PVAS went from 8.2±2.2 pre-operatively to 5.2(±1.7) post-operatively reaching 3.4±1.9 at the latest follow-up (P<0.001). Mean LSA decreased from 13.2⁰(±5.78) pre-operatively to 6.11⁰(±8.51)(P<0.001) post-operatively and reached 7.56⁰(±7.55) at the latest follow-up(P=0.59). Complications occurred in 39(15.4%) patients. One-third of those were mechanical(rod/screw fracture, cement displacement) needing re-intervention in 4 patients(1.6%).

Conclusions: The mechanical stability offered by the cement-based anterior reconstruction is maintained during the lifespan of patients operated for the spinal metastasis. Satisfying functional and radiological outcomes observed at the last follow-up show that this lasting, cost sparing, and relatively simple reconstruction technique, is a valid alternative for the costly and more complicated cage-based reconstruction.