Abstract
As treatment options have prolonged the lives of patients with advanced oncologic disease, spinal metastases have become increasingly prevalent. By definition, spine surgery addressing metastases occurs within a complex cohort of patients all of whom have an aggressive form of cancer in addition to multiple comorbidities that serve as barriers to proper wound healing. The purpose of this chapter is to explore the various components of wound healing in the context of metastatic spine tumors. Wound management after surgery for metastatic disease of the spine requires not only a knowledge of fundamental wound-healing physiology and management but also how these principles are altered in this particular patient cohort.
This chapter begins with a review of wound healing and how this may be altered in a patient with metastatic disease of the spine. The focus then shifts to management, beginning with medical optimization of patients prior to surgery and highlighting the benefits of a multidisciplinary approach. Reconstructive options are discussed for both primary and revision spinal surgery. Finally, the chapter closes with a review of postoperative management and how to handle common wound complications following spinal closure.
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Bernstein, J.L., Wright, M.A., Spector, J.A. (2020). Optimizing Wound Healing in Metastatic Spine Surgery. In: Ramakrishna, R., Magge, R., Baaj, A., Knisely, J. (eds) Central Nervous System Metastases. Springer, Cham. https://doi.org/10.1007/978-3-030-42958-4_48
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DOI: https://doi.org/10.1007/978-3-030-42958-4_48
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