The Recovery of Neurological Function and Walking Ability After Total En Bloc Spondylectomy for Spinal Tumors

Background and objective Total en bloc spondylectomy (TES) is an excision surgery for spinal tumors. TES is a procedure that requires tremendous skills, and hence it is associated with a potential risk of neurological complications. This study aimed to examine the incidence of postoperative neurological dysfunction and to evaluate the recovery of neurological outcomes and walking ability after TES. Methods We identified 71 patients who underwent TES for primary and metastatic spine tumors between 2010 and 2017. Perioperative neurological function and ambulation status were evaluated preoperatively, at one week, and one, three, and six months postoperatively. Results Postoperative neurological deficits were observed in 26 patients (37%). In patients with preoperative neurological deficits, an improved modified Frankel grade was observed up to six months (22/31, 71%). Six months after the surgery, the ambulation rate was significantly higher compared to that before surgery. All 14 of 40 patients (35%) with no neurological deficits preoperatively who had neurological deficits postoperatively recovered the neurological function and were able to walk at three months postoperatively. Conclusions Although some patients in our cohort showed postoperative neurological deterioration after TES, their neurological function and walking ability continued to improve over a prolonged period.