[Surgical treatment results of metastatic spine disease with using minimally invasive technologies, including 3D video endoscopic technologies]

THE AIM OF THE STUDY

Was to evaluate the results of surgical treatment of patients with metastatic lesions of the spine using 3-D video endoscopic technologies.

MATERIAL AND METHODS

We analysed the results of surgical treatment of 33 patients with metastatic lesions of the thoracic spine using a 3D video-assisted thoracoscopic intervention that was performed from November 2017 to December 2019. When examining patients, the following were used: X-ray of the spine, spiral computed tomography (CT), magnetic resonance imaging (MRI), as well as the SINS, Bilsky, Karnovsky, Tokuhashi, Frankel, SF-36 and VAS scales.

RESULTS

The actual life expectancy of the patients completely coincided with the predicted one according to the Tokuhashi scale. Regression of neurological disorders in the early postoperative period (before discharge from the hospital) was observed in 6% of patients (complete in 3%, partial in 3%). When evaluating the results of treatment 12 months after surgery, regression of neurological symptoms was observed in 19% of patients. At the same time, complete regression of neurological disorders occurred in 10%, partial in 9% of patients. When assessing the quality of life on the SF-36 scale, improvement was observed according to the most of the criteria. Also, in the postoperative period, there was a persistent decrease in the intensity of pain syndrome according to VAS compared with the preoperative level.

CONCLUSION

The use of 3-D video endoscopic technologies in the surgical treatment of patients with metastatic lesions of the spine made it possible to improve the quality of life of patients and reduce the number of complications.

Reconstruction by bone transport after resection of benign tumors of tibia: A retrospective study of 38 patients

BACKGROUND

The commonly used reconstructive options after post resection defects in bone tumors like megaprosthesis, autograft, allograft, bone graft substitutes and recycled bone have their own demerits on a long term. Bone transport that regenerates patient's own bone is a less explored option of reconstruction after resection of benign bone tumors and reports on this are limited. This technique is very much relevant in tibia where Ilizarov fixator is surgeon and patient friendly. We report our experience.

MATERIALS AND METHODS

This is a retrospective series of resection and bone transport in 38 patients with benign tumor of tibia. There were 14 males and 24 females with mean age of 23.40 years (range 9-40 years). Lesion was located in proximal third tibia in 27, middle third in two and distal third in nine patients. The diagnosis was giant cell tumor in 32, chondroblastoma in three, chondromyxoid fibroma, enchondroma and desmoplasic fibroma in one patient each. The resection was intercalary in 28 and transarticular in 10 patients. Osteosynthesis was monofocal in three, bifocal in 31 and polyfocal in four cases.

RESULTS

Mean followup was 7.22 years (range 1.5-15 years). Mean resection length was 10.21 cm (range 3-22 cm). The mean duration of external fixator was 308.03 days (range 89-677 days) and mean external fixator index was 36.14 days/cm (range 16.84-97.43 days/cm). Twelve patients had difficulties in the form of 11 problems and five obstacles that were successfully managed. None of the patients had local recurrence of tumor or any long term complication. Mean Musculo-skeletal Tumour Society score at final followup was 27.18 (90.60%).

CONCLUSIONS

Bone transport is an excellent option after resection of benign tumors of tibia with good local control and functional outcome, despite minor difficulties that need timely management.