Lumbar corpectomy for correction of degenerative scoliosis from osteoradionecrosis reveals a delayed complication of lumbar myxopapillary ependymoma

Authors

Sheri K. Palejwala, University of Arizona, Department of Surgery, Division of Neurosurgery, 1501 N. Campbell Avenue, Tucson, AZ 85724-5070, USA.
Kevin A. Lawson, University of Arizona, Department of Orthopaedic Surgery, 1501 N. Campbell Avenue, Tucson, AZ 85724-5070, USA.
Sean L. Kent, University of Arizona, College of Medicine, 1501 N. Campbell Avenue, Tucson, AZ 85724-5070, USA. Electronic address: seanlkent@email.arizona.edu.
Nikolay L. Martirosyan, University of Arizona, Department of Surgery, Division of Neurosurgery, 1501 N. Campbell Avenue, Tucson, AZ 85724-5070, USA.Follow
Travis M. Dumont, University of Arizona, Department of Surgery, Division of Neurosurgery, 1501 N. Campbell Avenue, Tucson, AZ 85724-5070, USA.

Document Type

Article

Abstract

Osteoradionecrosis is a known complication following radiation therapy, presenting most commonly in the cervical spine as a delayed consequence of radiation that is often necessary in the management of head and neck cancers. In contrast, osteoradionecrosis has rarely been described in the lumbar spine. Here we describe, to our knowledge, the first reported case of lumbar spine osteoradionecrosis, after adjuvant radiation for a primary spinal cord tumor, leading to progressive degenerative scoliosis which required subsequent operative management. Established guidelines recommend that mature bone can tolerate a dose of up to 6000 cGy without injury. However, once bone has been exposed to radiation over this level progressive soft tissue changes may lead to devascularization, leaving the bone vulnerable to osteonecrosis, specifically when manipulated. Radiation necrosis can be progressive and lead to eventual mechanical instability requiring debridement and surgical fixation. In the setting of the lumbar spine, osseous necrosis can lead to biomechanical instability, deformity, pain, and neurologic deficit.

Medical Subject Headings

Aged; Ependymoma (complications, diagnostic imaging, surgery); Humans; Lumbar Vertebrae (diagnostic imaging, surgery); Male; Osteoradionecrosis (complications, diagnostic imaging, surgery); Radiation Injuries (complications, diagnostic imaging, surgery); Scoliosis (diagnostic imaging, etiology, surgery); Spinal Fusion (instrumentation, methods); Spinal Neoplasms (complications, diagnostic imaging, surgery)

Publication Date

8-1-2016

Publication Title

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

E-ISSN

1532-2653

Volume

30

First Page

160

Last Page

162

PubMed ID

27056674

Digital Object Identifier (DOI)

10.1016/j.jocn.2016.02.010

Recommended Citation

Palejwala, Sheri K.; Lawson, Kevin A.; Kent, Sean L.; Martirosyan, Nikolay L.; and Dumont, Travis M., "Lumbar corpectomy for correction of degenerative scoliosis from osteoradionecrosis reveals a delayed complication of lumbar myxopapillary ependymoma" (2016). Neurosurgery. 1700.
https://scholar.barrowneuro.org/neurosurgery/1700