Cancer Management and Research (Apr 2021)

Factors Related to Instrumentation Failure in Titanium Mesh Reconstruction for Thoracic and Lumbar Tumors: Retrospective Analysis of 178 Patients

  • Bao WD,
  • Jia Q,
  • Wang T,
  • Lou Y,
  • Jiang DJ,
  • Yang C,
  • Yang X,
  • Huang Q,
  • Wei HF,
  • Xiao JR

Journal volume & issue
Vol. Volume 13
pp. 3345 – 3355

Abstract

Read online

Wei-Dong Bao,1,* Qi Jia,2,* Tao Wang,2,3,* Yan Lou,2 Dong-Jie Jiang,2 Cheng Yang,2 Xinghai Yang,2 Quan Huang,2 Hai-Feng Wei,2 Jian-Ru Xiao1,2 1Department of Orthopedics, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, People’s Republic of China; 2Department of Orthopedic Oncology, Spinal Tumor Center, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People’s Republic of China; 3Department of Orthopeadics, Second Affiliated Hospital of Anhui Medical University, Hefei, 230000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hai-Feng Wei; Jian-Ru XiaoDepartment of Orthopedic Oncology, Spine Tumor Center, Changzheng Hospital, Second Military Medical University, #415 Fengyang Road, Shanghai, 200003, People’s Republic of ChinaTel +86-21-81886843Email [email protected]; [email protected]: To investigate risk factors for instrumentation failure (IF) in titanium (Ti) mesh reconstruction for thoracic and lumbar tumors.Patients and Methods: The clinical data of patients with thoracic or lumbar tumors who received Ti mesh reconstruction via the posterior approach in our hospital from 2013 to 2018 were analyzed retrospectively. The observation indexes included sex, age, BMI, the vertebra resection mode, the number of resected vertebral segments, application of bone cement, radiotherapy, chemotherapy, revision or primary surgery, and primary tumor metastasis. Correlations between these factors and IF were analyzed by Kaplan–Meier survival and logistics regression analyses.Results: The 178 patients included 108 males and 70 females with a mean age of 48.09± 16.21 (6– 78) years and a mean follow-up period of 51.18 (24– 90) months. The data showed that 17 patients (9.55%) were inflicted with IF, involving the thoracic vertebra in 11 cases, thoracolumbar vertebrae (T12–L1) in 2 cases, and lumbar vertebrae in 4 cases. The mean interval between surgery to IF was 35.18± 14.17 (14– 59) months. Univariate analysis showed that total vertebral body resection, the number of resected vertebral segments, radiotherapy and multiple tumor resection were potential factors for IF, while multivariate analysis showed that only total vertebral body resection, the number of resected vertebral segments and radiotherapy were independent factors.Conclusion: Total vertebra resection, the number of resected vertebral segments (≥ 2) and radiotherapy before and after operation were significant risk factors related to IF.Keywords: instrumentation failure, titanium mesh, thoracic and lumbar tumors

Keywords