{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:50:08Z","timestamp":1747187408542,"version":"3.40.5"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T00:00:00Z","timestamp":1717977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>It is always difficult to obtain a comfortable surgical margin for patients with recurrent malignant or invasive benign spinal tumors. Tumor intraspinal invasion and dural adhesion are the essential reasons. There are always residual tumor cells maintained at the edge of dura. Dural resection is a key point to obtain a comfortable surgical margin for such cases. Whether such patients benefit from this risky surgical procedure is unknown. This study aims to understand better the oncological results, associated risks, and neurological function of this risky surgical procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed clinical data from six consecutive patients who registered spinal tumors in our institute and underwent dural resection during en bloc spinal resection from June 2013 to May 2020. The demographic and perioperative data, oncological outcomes, complications, and neurological status were collected and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All six patients were followed up for 24 to 46\u2009months (mean follow\u2010up time: 32.8\u2009months). Local recurrence was detected in one patient (1\/6, 16.7%) at 36\u2009months postoperatively and in five patients with no evidence of disease at the last follow up (survival rate 83.3%). Eleven complications occurred in four patients (66.7%), and the dural resection\u2010related complications included only four cases of cerebrospinal fluid leakage (CSFL), which accounted for 36.4% (4\/11) of all complications. Neurologic status evaluated by the Frankel grade showed improvement of one grade in one case and deterioration of one to two grades in five patients immediately after surgery. All deterioration cases recovered to the preoperative level 6\u2009months after the operation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Dural resection is significant for patients with dura matter invaded by recurrent primary malignant or invasive benign spinal tumors with the purpose of clinical cure. This study demonstrated that in strictly selected cases, intentional dural resection could provide satisfying local control and long\u2010term disease\u2010free survival with acceptable complications and satisfying neurological function.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.14104","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T06:55:03Z","timestamp":1718088903000},"page":"1753-1760","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intentional Dural Resection during en bloc Spinal Resection Could Provide a Secure Surgical Margin for Patients with Recurrent Spinal Tumors"],"prefix":"10.1111","volume":"16","author":[{"given":"Zhiye","family":"Du","sequence":"first","affiliation":[{"name":"Musculoskeletal Tumor Center Peking University People's Hospital  Beijing 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People's Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Wang","sequence":"additional","affiliation":[{"name":"Musculoskeletal Tumor Center Peking University People's Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,6,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000251045.79708.7a"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000002386"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3171\/2015.7.SPINE15201"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.84B5.0840712"},{"key":"e_1_2_10_6_1","first-page":"69","article-title":"Spinal dural resection for oncological purposes: a systematic analysis of risks and outcomes in patients with malignant spinal tumors","volume":"1","author":"Barber 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