TY - JOUR

T1 - Факторы риска нестабильности имплантатов после спондилэктомии у пациентов с опухолями позвоночника

AU - Zaborovskii, N.S.

AU - Masevnin, S.V.

AU - Murakhovsky, V.S.

AU - Mukhiddinov, R.A.

AU - Smekalyonkov, O.A.

AU - Ptashnikov, D.A.

N1 - Export Date: 05 February 2026; Cited By: 1; Correspondence Address: N.S. Zaborovskii; Vreden National Medical Research Center of Traumatology and Orthopedics, Saint-Petersburg, Russian Federation; email: n.zaborovskii@yandex.ru

PY - 2025

Y1 - 2025

N2 - Introduction Total spondylectomy for spinal tumors provides optimal local control and is associated with a high risk of implant instability. The objective was to determine risk factors for implant instability after spondylectomy in patients with neoplastic lesions of the spine. Material and methods A retrospective cohort study included patients with spinal tumors treated with tumor resection between 2007 and 2023. Inclusion criteria were spondylectomy and vertebral body replacement, thoracic or lumbar spine localization, follow-up period ≥ 12 months. LASSO regression and Random Forest methods and multivariate analysis were used to identify instability predictors. Results Implant instability was observed in 16 patients (18.4 %). Risk factors included the use of bone cement instead of allograft (OR = 0.125, p = 0.014), contact surface mismatch > 10° (OR = 0.214, p = 0.026), prosthesis subsidence > 2 mm at 3 months (OR = 4.497, p = 0.023). Discussion The risk factors identified had a great clinical role for the prevention of implant instability. The use of bone graft instead of cement, precise matching of contact surfaces and control of early prosthetic subsidence can significantly reduce the risk of metal construct failure. Careful preoperative planning and regular postoperative monitoring are essential for the outcome. Conclusion Three independent risk factors for implant instability after spondylectomy identified in patients with spinal tumor lesions included the use of bone cement instead of allograft, a discrepancy between the contact prosthetic surfaces of more than 10°, and an implant subsidence of more than 2 mm after 3 months. These factors are important for planning of the surgical intervention and postoperative monitoring to prevent metal construct instability. © Zaborovskii N.S., Masevnin S.V., Murakhovsky V.S., Mukhiddinov R.A., Smekalyonkov O.A., Ptashnikov D.A., 2025 © Translator Irina A. Saranskikh, 2025

AB - Introduction Total spondylectomy for spinal tumors provides optimal local control and is associated with a high risk of implant instability. The objective was to determine risk factors for implant instability after spondylectomy in patients with neoplastic lesions of the spine. Material and methods A retrospective cohort study included patients with spinal tumors treated with tumor resection between 2007 and 2023. Inclusion criteria were spondylectomy and vertebral body replacement, thoracic or lumbar spine localization, follow-up period ≥ 12 months. LASSO regression and Random Forest methods and multivariate analysis were used to identify instability predictors. Results Implant instability was observed in 16 patients (18.4 %). Risk factors included the use of bone cement instead of allograft (OR = 0.125, p = 0.014), contact surface mismatch > 10° (OR = 0.214, p = 0.026), prosthesis subsidence > 2 mm at 3 months (OR = 4.497, p = 0.023). Discussion The risk factors identified had a great clinical role for the prevention of implant instability. The use of bone graft instead of cement, precise matching of contact surfaces and control of early prosthetic subsidence can significantly reduce the risk of metal construct failure. Careful preoperative planning and regular postoperative monitoring are essential for the outcome. Conclusion Three independent risk factors for implant instability after spondylectomy identified in patients with spinal tumor lesions included the use of bone cement instead of allograft, a discrepancy between the contact prosthetic surfaces of more than 10°, and an implant subsidence of more than 2 mm after 3 months. These factors are important for planning of the surgical intervention and postoperative monitoring to prevent metal construct instability. © Zaborovskii N.S., Masevnin S.V., Murakhovsky V.S., Mukhiddinov R.A., Smekalyonkov O.A., Ptashnikov D.A., 2025 © Translator Irina A. Saranskikh, 2025

KW - implant instability

KW - risk factor

KW - spinal tumors

KW - spondylectomy

KW - vertebral body replacement

U2 - 10.18019/1028-4427-2025-31-2-183-193

DO - 10.18019/1028-4427-2025-31-2-183-193

M3 - статья

VL - 31

SP - 183

EP - 193

JO - ГЕНИЙ ОРТОПЕДИИ

JF - ГЕНИЙ ОРТОПЕДИИ

SN - 1028-4427

IS - 2

ER -