Case Series of Ultrasonic Navigated Osteotomy for the Treatment of Spinal Chordomas.
Adult
Blood Loss, Surgical
Chordoma
/ diagnostic imaging
Cohort Studies
Disease-Free Survival
Female
Follow-Up Studies
Humans
Length of Stay
Magnetic Resonance Imaging
Male
Middle Aged
Neurosurgical Procedures
/ methods
Osteotomy
/ methods
Reoperation
Spinal Neoplasms
/ diagnostic imaging
Surgery, Computer-Assisted
/ methods
Tomography, X-Ray Computed
Treatment Outcome
Ultrasonics
Ultrasonography
Case series
En bloc resection
Navigated ultrasonic osteotomy
Piezosurgery
Spinal oncology
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
received:
20
11
2020
revised:
28
02
2021
accepted:
01
03
2021
pubmed:
12
3
2021
medline:
21
8
2021
entrez:
11
3
2021
Statut:
ppublish
Résumé
Chordomas present challenges for en bloc surgical resection, which optimally reduces local recurrence and increases patient survival. Navigated ultrasonic osteotomy, also known as piezosurgery, provides a distinct advantage for achieving negative margins after en bloc resection. Eight consecutive patients with chordomas (2 cervical, 3 lumbar, and 3 sacral) treated with navigated ultrasonic osteotomy to achieve en bloc resection were identified from our institutional spine tumor database (2016-2019) and retrospectively reviewed. En bloc resection, with negative margins, was achieved in all cases. Two patients (25%) were women, and mean age at surgery was 44 ± 11 years. Median estimated blood loss was 1000 mL (interquartile range: 263-1500 mL). Median length of hospital stay was 10 days (interquartile range: 3-19.5 days). Two patients required a revision procedure. Two patients had complications requiring readmission within the 30-day postoperative window. Mean duration of follow-up for the cohort was 900 ± 554 days. Navigated ultrasonic osteotomy is an effective surgical technique to achieve en bloc resection of chordomas with negative margins and disease-free survival. To date, this represents the first reported cohort of patients undergoing the procedure as described here. Future studies should include larger sample sizes for more robust clinical outcome data to further elucidate the benefits of piezosurgery for obtaining en bloc chordoma resection.
Sections du résumé
BACKGROUND
Chordomas present challenges for en bloc surgical resection, which optimally reduces local recurrence and increases patient survival. Navigated ultrasonic osteotomy, also known as piezosurgery, provides a distinct advantage for achieving negative margins after en bloc resection.
METHODS
Eight consecutive patients with chordomas (2 cervical, 3 lumbar, and 3 sacral) treated with navigated ultrasonic osteotomy to achieve en bloc resection were identified from our institutional spine tumor database (2016-2019) and retrospectively reviewed.
RESULTS
En bloc resection, with negative margins, was achieved in all cases. Two patients (25%) were women, and mean age at surgery was 44 ± 11 years. Median estimated blood loss was 1000 mL (interquartile range: 263-1500 mL). Median length of hospital stay was 10 days (interquartile range: 3-19.5 days). Two patients required a revision procedure. Two patients had complications requiring readmission within the 30-day postoperative window. Mean duration of follow-up for the cohort was 900 ± 554 days.
CONCLUSIONS
Navigated ultrasonic osteotomy is an effective surgical technique to achieve en bloc resection of chordomas with negative margins and disease-free survival. To date, this represents the first reported cohort of patients undergoing the procedure as described here. Future studies should include larger sample sizes for more robust clinical outcome data to further elucidate the benefits of piezosurgery for obtaining en bloc chordoma resection.
Identifiants
pubmed: 33706017
pii: S1878-8750(21)00367-3
doi: 10.1016/j.wneu.2021.03.001
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e347-e352Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.