Short-segment cement-augmented fixation in open separation surgery of metastatic epidural spinal cord compression: initial experience

OBJECTIVE High-grade metastatic epidural spinal cord compression from radioresistant tumor histologies is often treated with separation surgery and adjuvant stereotactic body radiation therapy. Historically, long-segment fixation performed during posterior transpedicular of a minimum 2 levels superior inferior to the decompression. Previous experience minimal access techniques percutaneous stabilization have highlighted reduced morbidity as an advantage use shorter constructs. Cement augmentation pedicle screws attractive option for enhanced while performing fixation. Herein, authors describe their initial open using short-segment cement-augmented screw reconstruction. METHODS The retrospective chart review patients undergoing (i.e., nonpercutaneous, surgery) high-grade at single adjacent decompression level(s). Patient demographics, treatment data, operative complications, short-term radiographic outcomes were evaluated. RESULTS Overall, 44 met inclusion criteria follow-up mean 8.5 months. Involved included 19 thoracic, 5 thoracolumbar, 20 lumbar. through fenestrated was in 30 patients, vertebroplasty-type approach used remaining 14 augment purchase. One (2%) patient required revision hardware complication. Three (7%) nonoperative complications occurred, including 1 pathologic fracture index level causing progressive kyphosis incidences haloing around screw. There wound that managed conservatively without intervention. No cement-related occurred. CONCLUSIONS Open posterolateral utilizing viable alternative instrumentation reconstruction following spine tumors. Studies longer are needed determine rates delayed durability these outcomes.