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Wound complications following spine tumor surgery: Risk factors and prevention 脊柱肿瘤手术后的伤口并发症：风险因素与预防
Seminars in Spine Surgery Pub Date : 2024-11-04 DOI: 10.1016/j.semss.2024.101138
Chukwuka Obiofuma, Addisu Mesfin
{"title":"Wound complications following spine tumor surgery: Risk factors and prevention","authors":"Chukwuka Obiofuma,&nbsp;Addisu Mesfin","doi":"10.1016/j.semss.2024.101138","DOIUrl":"10.1016/j.semss.2024.101138","url":null,"abstract":"<div><div>Surgical site infections (SSI) and wound complications are common following primary and metastatic spine tumor surgery. Some risks factors include pre-operative radiation therapy, malnutrition, revision surgeries, length of surgery and co-morbidities. Some strategies to decrease wound complications include plastic surgery closure and use of betadine irrigation and vancomycin intrawound power. However, larger series prospective randomized studies are needed in order advance the field of spine oncology and to continue to decrease wound complications.</div></div>","PeriodicalId":39884,"journal":{"name":"Seminars in Spine Surgery","volume":"36 4","pages":"Article 101138"},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Update on the management of extradural primary pediatric spinal tumors 硬膜外原发性小儿脊柱肿瘤的最新治疗方法
Seminars in Spine Surgery Pub Date : 2024-11-01 DOI: 10.1016/j.semss.2024.101140
Chukwuemeka Mbagwu, Lancelot Benn, Addisu Mesfin
{"title":"Update on the management of extradural primary pediatric spinal tumors","authors":"Chukwuemeka Mbagwu,&nbsp;Lancelot Benn,&nbsp;Addisu Mesfin","doi":"10.1016/j.semss.2024.101140","DOIUrl":"10.1016/j.semss.2024.101140","url":null,"abstract":"<div><div>Osseous/extradural pediatric spine tumors are uncommon and divided into benign and malignant. The Enneking classification is used to divide the benign tumors into latent, benign aggressive and aggressive. The malignant spine tumors include osteosarcoma, Ewing's sarcoma and lymphoma. A tissue biopsy is crucial for diagnosis and is essential to manage these tumors in a multi-disciplinary manner.</div></div>","PeriodicalId":39884,"journal":{"name":"Seminars in Spine Surgery","volume":"36 4","pages":"Article 101140"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Interventional radiology procedures for metastatic spine tumors 治疗转移性脊柱肿瘤的介入放射学程序
Seminars in Spine Surgery Pub Date : 2024-10-31 DOI: 10.1016/j.semss.2024.101135
Lauren Park , Nora Tabori , John Smirniotopoulos
{"title":"Interventional radiology procedures for metastatic spine tumors","authors":"Lauren Park ,&nbsp;Nora Tabori ,&nbsp;John Smirniotopoulos","doi":"10.1016/j.semss.2024.101135","DOIUrl":"10.1016/j.semss.2024.101135","url":null,"abstract":"<div><h3>Objective</h3><div>Interventional radiology procedures can offer locoregional tumor control and palliative options for patients with metastatic disease to spine to relieve pain, to delay neurologic deficits, and to improve quality of life and daily function.</div></div><div><h3>Findings</h3><div>Multiple thermal energies for percutaneous ablation of metastases to the spine exist and are chosen according to tumor characteristics, volume, and location. Vertebral augmentation is most often combined with ablation for structural stability. Intravascular embolization of metastases provides tumor palliative or presurgical devascularization.</div></div><div><h3>Conclusion</h3><div>Ablation, vertebral augmentation, and intravascular embolization are efficacious minimally invasive options for the management of spinal tumors.</div></div>","PeriodicalId":39884,"journal":{"name":"Seminars in Spine Surgery","volume":"36 4","pages":"Article 101135"},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advanced radiation therapy options for primary and metastatic spine tumors 原发性和转移性脊柱肿瘤的先进放射治疗方案
Seminars in Spine Surgery Pub Date : 2024-10-28 DOI: 10.1016/j.semss.2024.101136
Akrita Bhatnagar , Timothy Kearney , Susan M. Woody, Keith R. Unger, Matthew E. Witek
{"title":"Advanced radiation therapy options for primary and metastatic spine tumors","authors":"Akrita Bhatnagar ,&nbsp;Timothy Kearney ,&nbsp;Susan M. Woody,&nbsp;Keith R. Unger,&nbsp;Matthew E. Witek","doi":"10.1016/j.semss.2024.101136","DOIUrl":"10.1016/j.semss.2024.101136","url":null,"abstract":"<div><div>Primary spinal cord and metastatic spine tumors represent a heterogenous group of malignancies whose management is complex given the variety of tumor histologies, tumor-related morbidity, and potential complications of treatment. The critical role of radiation therapy in the management of primary spinal cord and metastatic spine tumors has been influenced by advances in neurosurgical techniques, neuroimaging, integrative diagnoses, and most impactfully through advances in radiotherapy technology specifically stereotactic radiotherapy and proton therapy. This article reviews contemporary literature supporting the use of advanced radiotherapy in the management of primary spinal cord and metastatic spine tumors.</div></div>","PeriodicalId":39884,"journal":{"name":"Seminars in Spine Surgery","volume":"36 4","pages":"Article 101136"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of intradural extramedullary and intramedullary spinal tumors 硬膜外髓内和髓内脊柱肿瘤的管理
Seminars in Spine Surgery Pub Date : 2024-10-28 DOI: 10.1016/j.semss.2024.101141
Amanda Roehrkasse, Jeffrey Breton, Jean-Marc Voyadzis
{"title":"Management of intradural extramedullary and intramedullary spinal tumors","authors":"Amanda Roehrkasse,&nbsp;Jeffrey Breton,&nbsp;Jean-Marc Voyadzis","doi":"10.1016/j.semss.2024.101141","DOIUrl":"10.1016/j.semss.2024.101141","url":null,"abstract":"<div><div>Intradural spine tumors are relatively uncommon and include tumors outside (extramedullary) or within the spinal cord (intramedullary). The proximity of these tumors to important neural structures can cause significant neurologic morbidity and prompt management is critical for maintaining function. Surgical intervention is generally the primary treatment depending on presenting symptoms, radiologic features, and the likelihood of a clear surgical planes vis-à-vis the spinal cord. Adjuvant radiation, chemotherapy, or other novel therapeutic strategies may play a role in postoperative management. Here we review management strategies for common intradural extramedullary (meningiomas, schwannomas, and neurofibromas) and intradural intramedullary tumors (astrocytomas, ependymomas, and hemangioblastomas).</div></div>","PeriodicalId":39884,"journal":{"name":"Seminars in Spine Surgery","volume":"36 4","pages":"Article 101141"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Minimally invasive management of metastatic spine tumors 微创治疗转移性脊柱肿瘤
Seminars in Spine Surgery Pub Date : 2024-10-28 DOI: 10.1016/j.semss.2024.101134
Atousa Nourmahnad , Matiar Jafari , Thomas E Olson , Andrew C. Vivas , Elizabeth L. Lord
{"title":"Minimally invasive management of metastatic spine tumors","authors":"Atousa Nourmahnad ,&nbsp;Matiar Jafari ,&nbsp;Thomas E Olson ,&nbsp;Andrew C. Vivas ,&nbsp;Elizabeth L. Lord","doi":"10.1016/j.semss.2024.101134","DOIUrl":"10.1016/j.semss.2024.101134","url":null,"abstract":"<div><div>Minimally invasive spine surgery is primed for innovation and development. As imaging and navigations modalities continue to develop, their impact on clinical outcomes and patient quality of life is expected to be substantial, marking a significant step forward in neurosurgical practice. By combining these advanced technologies with minimally invasive surgical approaches and adjuvant therapies, we are bound to significantly improve patient outcomes, minimize neurological deficits, and enhance the overall quality of life for patients with spinal tumors.</div></div>","PeriodicalId":39884,"journal":{"name":"Seminars in Spine Surgery","volume":"36 4","pages":"Article 101134"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Overview and management of sacral tumors 骶骨肿瘤概述和治疗
Seminars in Spine Surgery Pub Date : 2024-10-28 DOI: 10.1016/j.semss.2024.101142
Douglass C. Johnson , S. Mohammed Karim , Addisu Mesfin
{"title":"Overview and management of sacral tumors","authors":"Douglass C. Johnson ,&nbsp;S. Mohammed Karim ,&nbsp;Addisu Mesfin","doi":"10.1016/j.semss.2024.101142","DOIUrl":"10.1016/j.semss.2024.101142","url":null,"abstract":"<div><div>Sacral tumors can range from benign to malignant. The sacrum is a common site of metastases however surgical intervention is not common for sacral metastases unless there is neurological compromise. Benign aggressive tumors such giant cell tumors, osteoblastomas and aneurysmal bone cysts (ABC) can be found in the sacrum. Malignant primary tumors including chordoma, chondrosarcomas and osteosarcomas can affect the sacrum. Management depends on the tumor histology including debulking and stabilization for metastatic spine lesions. For benign tumors such as ABCs, intralesional resection is an option. For primary spine tumors partial or total sacrectomies are an option and morbidity is dependent on the level of sacral resection.</div></div>","PeriodicalId":39884,"journal":{"name":"Seminars in Spine Surgery","volume":"36 4","pages":"Article 101142"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Total en bloc spondylectomy for primary tumors of the thoracic and lumbar spine: A review article 胸椎和腰椎原发性肿瘤的全脊椎切除术：综述文章
Seminars in Spine Surgery Pub Date : 2024-10-28 DOI: 10.1016/j.semss.2024.101137
Takaki Shimizu , Satoshi Kato , Noriaki Yokogawa , Takaaki Uto , Yuji Ishino , Kazuhiro Nanpo , Megumu Kawai , Hideki Murakami , Satoru Demura
{"title":"Total en bloc spondylectomy for primary tumors of the thoracic and lumbar spine: A review article","authors":"Takaki Shimizu ,&nbsp;Satoshi Kato ,&nbsp;Noriaki Yokogawa ,&nbsp;Takaaki Uto ,&nbsp;Yuji Ishino ,&nbsp;Kazuhiro Nanpo ,&nbsp;Megumu Kawai ,&nbsp;Hideki Murakami ,&nbsp;Satoru Demura","doi":"10.1016/j.semss.2024.101137","DOIUrl":"10.1016/j.semss.2024.101137","url":null,"abstract":"<div><div>Primary spine tumors present significant clinical challenges due to their potential for local invasiveness and metastasis. Total en bloc spondylectomy (TES) has emerged as a feasible surgical technique for the complete resection of thoracic and lumbar spinal tumors, providing superior local control and long-term survival benefits. This review synthesized the current evidence and clinical experiences and demonstrated that TES achieved lower recurrence rates and higher disease-free survival than those of piecemeal resection. Despite the high perioperative complication rates, TES is essential for treating primary spine tumors. The importance of skilled surgical teams to optimize patient outcomes has been emphasized.</div></div>","PeriodicalId":39884,"journal":{"name":"Seminars in Spine Surgery","volume":"36 4","pages":"Article 101137"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating the performance of the SORG machine learning algorithm for predicting discharge disposition in lumbar surgery patients 评估 SORG 机器学习算法在预测腰椎手术患者出院处置方面的性能
Seminars in Spine Surgery Pub Date : 2024-09-10 DOI: 10.1016/j.semss.2024.101132
Omar Salim , Mohamed S Draz , Emily R Bligh , Calan Mathieson
{"title":"Evaluating the performance of the SORG machine learning algorithm for predicting discharge disposition in lumbar surgery patients","authors":"Omar Salim ,&nbsp;Mohamed S Draz ,&nbsp;Emily R Bligh ,&nbsp;Calan Mathieson","doi":"10.1016/j.semss.2024.101132","DOIUrl":"10.1016/j.semss.2024.101132","url":null,"abstract":"<div><h3>Purpose</h3><div>Protracted admissions following lumbar surgeries are rising, often stemming from inefficient identification of patients requiring nonhome discharge for rehabilitation. The SORG Orthopaedic Research Group at Harvard Medical School have developed a machine learning algorithm for predicting discharge following lumbar surgery. This study assessed its predictive performance on an independent tertiary centre patient cohort.</div></div><div><h3>Methods</h3><div>Medical records were retrospectively reviewed for all elective adult lumbar disc degeneration or herniation surgeries performed between July 2017–2021 at a tertiary neurosurgical centre in the United Kingdom. Preoperative variables were collated and discharge destinations noted. Algorithm predictions were analysed using the concordance (c) statistic, Brier score and calibration plot. Positive and negative predictive values (PPV, NPV) were calculated, and a decision curve analysis (DCA) plotted.</div></div><div><h3>Results</h3><div>251 subjects were included (48.2 % female, mean age 55.3 years). 2.8 % underwent nonhome discharge. Most had surgery at 1/2 spinal levels (98.4 %) and were functionally independent (84.5 %). Algorithm predictions yielded a 0.88 c-statistic and 0.029 Brier score. The algorithm was miscalibrated to the data (calibration plot slope 1.31 and intercept -1.12). At a 0.25 threshold for nonroutine discharge risk, the PPV was 0.19 and NPV 0.98. DCA revealed limited clinical utility.</div></div><div><h3>Conclusions</h3><div>Algorithm predictive performance was mixed for this cohort, displaying strong discrimination but poor calibration and overestimation of nonroutine discharges. Differences in patient management practices and the low nonhome discharge rate may explain this. Larger validation studies across different healthcare systems, alongside geographically specific algorithm development, will improve predictive accuracy prior to clinical application.</div></div>","PeriodicalId":39884,"journal":{"name":"Seminars in Spine Surgery","volume":"36 4","pages":"Article 101132"},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implications of artificial intelligence 人工智能的影响
Seminars in Spine Surgery Pub Date : 2024-09-01 DOI: 10.1016/j.semss.2024.101122
Michael W. Fields, Nathan J. Lee, Ronald A. Lehman
{"title":"Implications of artificial intelligence","authors":"Michael W. Fields,&nbsp;Nathan J. Lee,&nbsp;Ronald A. Lehman","doi":"10.1016/j.semss.2024.101122","DOIUrl":"10.1016/j.semss.2024.101122","url":null,"abstract":"<div><p>The artificial intelligence (AI) revolution is underway. AI has become omnipresent in medicine, and its broad capabilities have permitted significant developments in many subspecialties including spine surgery. With AI, spine surgeons have been able to perform advanced computational analytics on vast amounts of data, allowing for solutions in each step of patient care from preoperative evaluation and planning, intraoperative execution, and postoperative evaluation. The tremendous potential of AI in medicine is clear and exciting. However, as the utility of AI in clinical practice expands, the medicolegal implications of this technology are poorly understood. In this chapter, we explore the existing technology, ethical considerations, legal challenges, and risk management strategies as it relates to AI in the field of spine surgery.</p></div>","PeriodicalId":39884,"journal":{"name":"Seminars in Spine Surgery","volume":"36 3","pages":"Article 101122"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142135787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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