Lateral lumbar vertebral body screw predisposes to neuralgia after limb-salvage surgery for pelvic tumors: a single-center, retrospective study of 349 cases

Abstract

Purpose: To investigate the incidence and risk factors of neuralgia after limb-salvage surgery for pelvic tumors with focus on the reconstruction methods.

Methods: We included 349 cases of pelvic tumors treated with internal hemipelvectomy and reconstruction in our center from January 2009 to May 2015. None of these cases had major lumbosacral nerves invaded by the tumors. Demographic and medical data were reviewed and documented for statistical analyses. The locations of lateral lumbar vertebral body screws (LLVBSs) were evaluated in 26 cases.

Results: The overall incidence of post-operative neuralgia was 8.3 %. Pre-admission requirement of analgesics (OR 4.089; 95 % CI 1.711-9.774) and application of LLVBS (OR 11.848; 95 % CI 4.369-32.129) were independent risk factors of neuralgia. The horizontal location of LLVBS did not affect the incidence of neuralgia when it was placed near the midline of the vertebra.

Conclusions: The incidence of post-operative neuralgia was 8.3 % in this study cohort. The LLVBS technique could increase the risk of post-operative neuralgia.

Keywords: Internal hemipelvectomy; Lateral lumbar vertebral body screw; Limb-salvage surgery; Neuralgia; Pelvic tumor.