The new clinical classification of metastatic spinal malignancies serves as a vital reference for surgical management: a retrospective case-control study

Autor: Junjun Bai, Jian Li, Jia Lv, Wangzhe Yang, Yushan Wang, Yi Feng, Zhi Lv
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: BMC Musculoskeletal Disorders, Vol 24, Iss 1, Pp 1-10 (2023)
Druh dokumentu: article
ISSN: 1471-2474
DOI: 10.1186/s12891-023-07092-4
Popis: Abstract Background It is commonly accepted that surgical treatment is an essential component of the comprehensive management of metastatic spinal malignancies. However, up until now, the clinical classification of metastatic spinal malignancies has not been well-structured. Methods After IRB approval, 86 patients with metastatic spinal malignancies were adopted. According to the vascular distribution, stability of vertebrae, and degree of nerve compression, metastatic spinal malignancies can be classified into five types. Tumors classified as type I typically appear in the vertebral body. Type II tumors are those that develop in the transverse processes, superior and inferior articular processes, and spinal pedicles. Type III denotes malignancies that are present in the spinous process and vertebral plate. Types IVa and IVb are included in type IV. Type IVa combines type I and type II, whereas type IVb combines type II and type III. Type V tumors are those of types I, II, and III that co-occur and spread in different directions into the spinal canal. 20 of included 86 patients who did not receive segmental arterial embolization were set as the non-embolization group. The embolization group included 24 patients who received segmental arterial embolization on both sides of the diseased vertebrae. 42 patients were included in the offending embolization group after receiving responsible arterial embolization. A surgical intervention was performed within 24 h following an embolization. Surgical intervention with the purpose of removing as much of the tumor as possible and providing an effective reconstruction of the spinal column. Results In comparison with the non-embolization group and embolization group, the offending embolization group presented unique advantages in terms of bleeding volume (p
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