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Surgical management of spinal metastases involving the cervicothoracic junction: results of a multicenter, European observational study

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Surgical management of spinal metastases involving the cervicothoracic junction: results of a multicenter, European observational study. / Hubertus, Vanessa; Gempt, Jens; Mariño, Michelle; Sommer, Björn; Eicker, Sven O; Stangenberg, Martin; Dreimann, Marc; Janssen, Insa; Wipplinger, Christoph; Wagner, Arthur; Lange, Nicole; Jörger, Ann-Kathrin; Czabanka, Marcus; Rohde, Veit; Schaller, Karl; Thomé, Claudius; Vajkoczy, Peter; Onken, Julia S; Meyer, Bernhard.

In: NEUROSURG FOCUS, Vol. 50, No. 5, E7, 05.2021.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Hubertus, V, Gempt, J, Mariño, M, Sommer, B, Eicker, SO, Stangenberg, M, Dreimann, M, Janssen, I, Wipplinger, C, Wagner, A, Lange, N, Jörger, A-K, Czabanka, M, Rohde, V, Schaller, K, Thomé, C, Vajkoczy, P, Onken, JS & Meyer, B 2021, 'Surgical management of spinal metastases involving the cervicothoracic junction: results of a multicenter, European observational study', NEUROSURG FOCUS, vol. 50, no. 5, E7. https://doi.org/10.3171/2021.2.FOCUS201067

APA

Hubertus, V., Gempt, J., Mariño, M., Sommer, B., Eicker, S. O., Stangenberg, M., Dreimann, M., Janssen, I., Wipplinger, C., Wagner, A., Lange, N., Jörger, A-K., Czabanka, M., Rohde, V., Schaller, K., Thomé, C., Vajkoczy, P., Onken, J. S., & Meyer, B. (2021). Surgical management of spinal metastases involving the cervicothoracic junction: results of a multicenter, European observational study. NEUROSURG FOCUS, 50(5), [E7]. https://doi.org/10.3171/2021.2.FOCUS201067

Vancouver

Hubertus V, Gempt J, Mariño M, Sommer B, Eicker SO, Stangenberg M et al. Surgical management of spinal metastases involving the cervicothoracic junction: results of a multicenter, European observational study. NEUROSURG FOCUS. 2021 May;50(5). E7. https://doi.org/10.3171/2021.2.FOCUS201067

Bibtex

@article{9ad343a3102b4f92bb70f99f76b98fbc,
title = "Surgical management of spinal metastases involving the cervicothoracic junction: results of a multicenter, European observational study",
abstract = "OBJECTIVE: Surgical management of spinal metastases at the cervicothoracic junction (CTJ) is highly complex and relies on case-based decision-making. The aim of this multicentric study was to describe surgical procedures for metastases at the CTJ and provide guidance for clinical and surgical management.METHODS: Patients eligible for this study were those with metastases at the CTJ (C7-T2) who had been consecutively treated in 2005-2019 at 7 academic institutions across Europe. The Spine Instability Neoplastic Score, neurological function, clinical status, medical history, and surgical data for each patient were retrospectively assessed. Patients were divided into four surgical groups: 1) posterior decompression only, 2) posterior decompression and fusion, 3) anterior corpectomy and fusion, and 4) anterior corpectomy and 360° fusion. Endpoints were complications, surgical revision rate, and survival.RESULTS: Among the 238 patients eligible for inclusion this study, 37 were included in group 1 (15%), 127 in group 2 (53%), 18 in group 3 (8%), and 56 in group 4 (24%). Mechanical pain was the predominant symptom (79%, 189 patients). Surgical complications occurred in 16% (group 1), 20% (group 2), 11% (group 3), and 18% (group 4). Of these, hardware failure (HwF) occurred in 18% and led to surgical revision in 7 of 8 cases. The overall complication rate was 34%. In-hospital mortality was 5%.CONCLUSIONS: Posterior fusion and decompression was the most frequently used technique. Care should be taken to choose instrumentation techniques that offer the highest possible biomechanical load-bearing capacity to avoid HwF. Since the overall complication rate is high, the prevention of in-hospital complications seems crucial to reduce in-hospital mortality.",
author = "Vanessa Hubertus and Jens Gempt and Michelle Mari{\~n}o and Bj{\"o}rn Sommer and Eicker, {Sven O} and Martin Stangenberg and Marc Dreimann and Insa Janssen and Christoph Wipplinger and Arthur Wagner and Nicole Lange and Ann-Kathrin J{\"o}rger and Marcus Czabanka and Veit Rohde and Karl Schaller and Claudius Thom{\'e} and Peter Vajkoczy and Onken, {Julia S} and Bernhard Meyer",
year = "2021",
month = may,
doi = "10.3171/2021.2.FOCUS201067",
language = "English",
volume = "50",
journal = "NEUROSURG FOCUS",
issn = "1092-0684",
publisher = "American Association of Neurological Surgeons",
number = "5",

}

RIS

TY - JOUR

T1 - Surgical management of spinal metastases involving the cervicothoracic junction: results of a multicenter, European observational study

AU - Hubertus, Vanessa

AU - Gempt, Jens

AU - Mariño, Michelle

AU - Sommer, Björn

AU - Eicker, Sven O

AU - Stangenberg, Martin

AU - Dreimann, Marc

AU - Janssen, Insa

AU - Wipplinger, Christoph

AU - Wagner, Arthur

AU - Lange, Nicole

AU - Jörger, Ann-Kathrin

AU - Czabanka, Marcus

AU - Rohde, Veit

AU - Schaller, Karl

AU - Thomé, Claudius

AU - Vajkoczy, Peter

AU - Onken, Julia S

AU - Meyer, Bernhard

PY - 2021/5

Y1 - 2021/5

N2 - OBJECTIVE: Surgical management of spinal metastases at the cervicothoracic junction (CTJ) is highly complex and relies on case-based decision-making. The aim of this multicentric study was to describe surgical procedures for metastases at the CTJ and provide guidance for clinical and surgical management.METHODS: Patients eligible for this study were those with metastases at the CTJ (C7-T2) who had been consecutively treated in 2005-2019 at 7 academic institutions across Europe. The Spine Instability Neoplastic Score, neurological function, clinical status, medical history, and surgical data for each patient were retrospectively assessed. Patients were divided into four surgical groups: 1) posterior decompression only, 2) posterior decompression and fusion, 3) anterior corpectomy and fusion, and 4) anterior corpectomy and 360° fusion. Endpoints were complications, surgical revision rate, and survival.RESULTS: Among the 238 patients eligible for inclusion this study, 37 were included in group 1 (15%), 127 in group 2 (53%), 18 in group 3 (8%), and 56 in group 4 (24%). Mechanical pain was the predominant symptom (79%, 189 patients). Surgical complications occurred in 16% (group 1), 20% (group 2), 11% (group 3), and 18% (group 4). Of these, hardware failure (HwF) occurred in 18% and led to surgical revision in 7 of 8 cases. The overall complication rate was 34%. In-hospital mortality was 5%.CONCLUSIONS: Posterior fusion and decompression was the most frequently used technique. Care should be taken to choose instrumentation techniques that offer the highest possible biomechanical load-bearing capacity to avoid HwF. Since the overall complication rate is high, the prevention of in-hospital complications seems crucial to reduce in-hospital mortality.

AB - OBJECTIVE: Surgical management of spinal metastases at the cervicothoracic junction (CTJ) is highly complex and relies on case-based decision-making. The aim of this multicentric study was to describe surgical procedures for metastases at the CTJ and provide guidance for clinical and surgical management.METHODS: Patients eligible for this study were those with metastases at the CTJ (C7-T2) who had been consecutively treated in 2005-2019 at 7 academic institutions across Europe. The Spine Instability Neoplastic Score, neurological function, clinical status, medical history, and surgical data for each patient were retrospectively assessed. Patients were divided into four surgical groups: 1) posterior decompression only, 2) posterior decompression and fusion, 3) anterior corpectomy and fusion, and 4) anterior corpectomy and 360° fusion. Endpoints were complications, surgical revision rate, and survival.RESULTS: Among the 238 patients eligible for inclusion this study, 37 were included in group 1 (15%), 127 in group 2 (53%), 18 in group 3 (8%), and 56 in group 4 (24%). Mechanical pain was the predominant symptom (79%, 189 patients). Surgical complications occurred in 16% (group 1), 20% (group 2), 11% (group 3), and 18% (group 4). Of these, hardware failure (HwF) occurred in 18% and led to surgical revision in 7 of 8 cases. The overall complication rate was 34%. In-hospital mortality was 5%.CONCLUSIONS: Posterior fusion and decompression was the most frequently used technique. Care should be taken to choose instrumentation techniques that offer the highest possible biomechanical load-bearing capacity to avoid HwF. Since the overall complication rate is high, the prevention of in-hospital complications seems crucial to reduce in-hospital mortality.

U2 - 10.3171/2021.2.FOCUS201067

DO - 10.3171/2021.2.FOCUS201067

M3 - SCORING: Journal article

C2 - 33932937

VL - 50

JO - NEUROSURG FOCUS

JF - NEUROSURG FOCUS

SN - 1092-0684

IS - 5

M1 - E7

ER -