Medium-Term Outcomes in Palliative Transpedicular Corpectomy With Cement-based Anterior Vertebral Reconstruction Performed for Patients With Spinal Metastasis

Retrospective study. The aim of this study was to assess the outcomes of single-stage posterior transpedicular corpectomy with cement-based anterior column support for spinal metastasis at longer follow-ups. Life expectancy of cancer patients is constantly increasing. Reliable anterior column reconstruction after posterior corpectomy becomes necessary. In this retrospective monocentric study, patients who underwent posterior transpedicular corpectomy and cement-based anterior reconstruction, with a minimum 6 months follow-up, were included. Ambulatory status and Pain Visual Analog Score (PVAS), complication rates, and local sagittal Cobb angle (LSA) were evaluated preoperatively, postoperatively, and at the latest follow-up. In total, 253 patients were included, with a mean follow-up of 21 months (6-132) and a median survival of 9 months. Preoperatively, 202 patients (81%) were ambulant, while 47 patients (19%) were not. At the latest follow-up, 241 patients (95%) were ambulant, while 12 patients (5%) were not ( P <0.001). Dorsal/lumbar PVAS went from 8.2&#xb1;2.2 preoperatively to 5.2&#xb1;1.7 postoperatively reaching 3.4&#xb1;1.9 at the latest follow-up ( P <0.001). Mean LSA decreased from 13.2 (&#xb1;5.78) degrees preoperatively to 6.11 (&#xb1;8.51) degrees ( P <0.001) postoperatively and reached 7.56 (&#xb1;7.55) degrees at the latest follow-up ( P =0.59). Complications occurred in 39 (15.4%) patients. One third of those were mechanical (rod/screw fracture, cement displacement) needing re-intervention in four patients (1.6%). The mechanical stability offered by the cement-based anterior reconstruction is maintained during the lifespan of patients operated for the spinal metastasis. Satisfying functional and radiologic outcomes observed at the last follow-up show that this lasting, cost sparing, and relatively simple reconstruction technique, is a valid alternative for the costly and more complicated cage-based reconstruction. Level 4.