• World Neurosurg · Aug 2023

    Review Meta Analysis

    Indications for fusion with intradural spine tumor resection in adults: A systematic review and meta-analysis.

    • Esteban Quiceno, Amna Hussein, Annie Pico, Ebtesam Abdulla, Isabel L Bauer, Kristin Nosova, Alexandros Moniakis, Monis Ahmed Khan, Dara S Farhadi, Michael Prim, and Ali Baaj.
    • Department of Neurosurgery, Banner University Medical Center, Phoenix, AZ, USA; Department of Neurosurgery, University of Arizona College of Medicine, Phoenix, AZ, USA. Electronic address: equicenor@gmail.com.
    • World Neurosurg. 2023 Aug 1; 176: 213021-30.

    BackgroundThe evidence for instrumented fusion in the setting of degenerative, traumatic, or congenital deformity is well established. Data on fusion indications in intradural spinal tumors (IDST) are scarce and reduced to retrospective studies. The objective of this work is to systematically review the published literature since 2015 and analyze the change of practice patterns for stabilization and fusion after intradural tumor resection in adults.MethodsA systematic literature review was performed via PubMed with the terms: "intradural spinal tumors", "intramedullary spinal tumors", and "intraspinal tumors". The analysis was limited to adult patients with IDST and studies with more than 10 patients. Data on the proportion of patients who underwent instrumentation and had postoperative deformity was pooled in a meta-analysis.ResultsA total of 1073 articles were identified and 47 papers were selected. All the studies were retrospective series and a total of 2473 patients were included. The follow-up ranged from 1 to 96 months, the pooled spinal fixation rate was 6% (95% CI 4.5%-7.6%), the pooled laminoplasty rate was 14.4% (95% CI 5.9%-23%), the pooled rate of postoperative deformity or malalignment in patients with a follow up of at least 6 months was 2.1% (95% CI 1.2%-3%) and just 7 patients were reoperated due to progressive deformity.ConclusionsBased on existing evidence, the rate of fusion during resection of intradural spinal tumors is low. Prophylactic fixation is often unnecessary and only indicated in unique cases that require extensive bony resection.Copyright © 2023 Elsevier Inc. All rights reserved.

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