Surgical approaches to L5 corpectomy: a systematic review.
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Authors
Hilis, Aaron
Issue Date
2020-12-01
Journal
Type
Article
Peer-Reviewed Publication
Peer-Reviewed Publication
Keywords
Adverse effects
L5 corpectomy
L5 vertebra
Lumbar vertebrae
Peer-reviewed article
Review
Spinal fusion
Spine surgery
Spondylectomy
Systematic review
Vertebrectomy
L5 corpectomy
L5 vertebra
Lumbar vertebrae
Peer-reviewed article
Review
Spinal fusion
Spine surgery
Spondylectomy
Systematic review
Vertebrectomy
Journal Title
European Spine Journal
Volume
29
Issue
12
Begin page
3074
End page
3079
Abstract
Introduction: Surgical approaches to pathologies of the L5 vertebra constitute a significant challenge. Our aim was to review the efficacy and safety of the surgical approaches to L5 corpectomy and reconstruction across the range of presenting pathology.
Materials and methods: This systematic review was conducted according to PRISMA guidelines, and databases were searched from 1970 to January 2020. The search inclusion criteria were L5 Corpectomy AND/OR Spondylectomy AND/OR Vertebrectomy. The outcome measures studied were length of surgery, blood loss, fusion or failure of fusion/instrumentation, complications and mortality.
Results: Initial 36 articles were identified, and final 6 studies met our inclusion criteria. The mean reported blood loss was 2265 ml (400-4700 ml) and was higher for the two-stage posterior-anterior surgery group than the posterior-only surgery group (mean 3230 mls vs. 1260 mls) but not the operative time. All surgical approaches shared high fusion rates (94%) and relatively low complication rates (11.7%). However, surgical strategies incorporating an anterior approach were notable for vascular complications (4-7%), as well as perioperative mortality (9%) not seen in the posterior-only surgery group.
Conclusion: Where there is clinical and circumstantial equipoise regarding the choice of surgical approaches for a L5 corpectomy, this review indicates a reported mean blood loss of 2265 ml (400-4700 ml), high fusion rates (94%) and relatively low complication rates (11.7%). It is difficult to make direct comparisons between approaches due to small case series, the variability in primary pathology, clinical intent and surgeon experience.
Citation
D'Aquino D, Tarawneh AM, Hilis A, Palliyil N, Deogaonkar K, Quraishi NA. Surgical approaches to L5 corpectomy: a systematic review. Eur Spine J. 2020 Oct 6.