Clinical efficacy of total spondylectomy in the treatment of spinal osteoblastoma

English Keywords:Spine  Osteoblastoma  Total spondylectomy  Imaging evaluation

English Abstract:

  【Abstract】 Objectives: To evaluate the clinical efficacy of total spondylectomy in the treatment of spinal osteoblastoma, in order to provide reference for clinical treatment. Methods: A retrospective analysis was conducted on 12 patients with thoracic and lumbar osteoblastoma underwent total spondylectomy in General Hospital of Northern Theater Command, Chinese People′s Liberation Army from January 2013 to January 2023. There were 7 male patients, 5 female patients, aged 33.8±9.4(15-45) years old, 8 patients with thoracic lesions and 4 patients with lumbar lesions. After pathological diagnosis, all the cases were treated with total spondylectomy, titanium mesh implantation and pedicle screw internal fixation. The operative time, blood loss, and complications were collected and recorded, and Frankel spinal cord injury grade, visual analogue scale(VAS) score, Japanese Orthopaedic Association(JOA) score, X-ray, CT and MRI imaging examinations were performed before and after operation to evaluate the function and imaging findings. The continuous variables were tested for normal distribution and homogeneity of variance, and paired t-test was used for statistical analysis of the data. All statistical analysis was carried out with SPSS software. Results: The patients were followed up for 4.7±2.8(2-10) years. The operative time was 4-6.5h (5.5±0.6h), and the blood loss was 1200-3080mL(2325.0±616.5mL). Frankel grade, 2 years after operation, 5 cases were improved by 1 grade, 4 cases by 2 grades, and 3 cases by 3 grades. The VAS score decreased from 5-9 points before operation to 1-4 points at 2 years after operation, the difference was statistically significant. The postoperative JOA score was significantly better than that before operation, and the improvement rate was 55%-92%. As for complications, incisional infection occurred in 2 cases and recovered well after local debridement and antibiotic treatment; Nerve injury was aggravated in 2 cases and recovered well after treatment such as dehydration, anti-inflammation and rehabilitation; 1 case developed pendant pneumonia, 1 case developed pleural effusion and pneumothorax, and the prognosis was good after corresponding treatment. At 1 month after operation, the placement of titanium mesh was accurate and the stability of internal fixation device was good in 10 cases, and the placement of titanium mesh was slightly shifted in 2 cases, but no spinal deformity and internal fixation failure occurred. Conclusions: Total spondylectomy has high clinical value in the treatment of osteoblastoma, which can effectively remove the tumor and reduce the occurrence of postoperative complications.