Alessandro Luzzati, Gennaro Scotto, Luca Cannavò, Alessandra Scotto di Uccio, Giuseppe Orlando, Luisa Petriello, Carmine Zoccali


December 2020, Volume 29, Issue 12, pp 3135 - 3147 Original Article Read Full Article 10.1007/s00586-020-06387-7

First Online: 01 April 2020

Purpose

Review a series of 22 patients below the age of 16 affected by primary bone tumors of the spine who underwent en bloc resection, and describe the clinical presentation, tumor characteristics, results and complications associated with the surgical treatment, underlining the specific issues related to a younger age.

Methods

We performed a review of all patients 

Results

Only 12/22 cases had not been previously treated. 22.7% experienced at least one early complication; 18.2% and 4.1% experienced at least 2 and ≥ 3 early complications, respectively; 40.9% experienced at least one late complication, often related to hardware failure (27.3%); 18.2% and 4.5% at least 2 and ≥ 3 late complications. No early nor late complications were experienced in 12 out of 22 patients (54.54%). The overall survival and the local recurrence-free survival at 5 years were, respectively, 79.5% and 74.8%; considering only the patients with high-grade tumors, they were 70.9% and 65.5%, respectively. At 77.3 months of median follow-up, 17 patients are still alive, 16 of whom without any evidence of disease and 1 with evidence of local and systemic disease; four patients died with evidence of local disease and one with distant metastases but no local recurrence.

Conclusions

Young people with primary malignant or locally aggressive bone tumors of the spine should be treated in specialized centers, and wide surgery should be performed. The most frequent problems are related to reconstruction in a growing spine and subsequent hardware failure that make later surgeries necessary.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.[graphic not available: see fulltext]


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