Risk analysis and nursing countermeasures for spinal tumor patients during total en bloc spondylectomy and spine reconstruction

Abstract

Objective To retrospectively summarize the risk factors in 6 spinal tumor patients during primary total en bloc spondylectomy (TES) , to give risk warning, and to propose nursing countermeasures. Methods Totally 6 spinal tumor patients received primary TES and transpedicular screw system fixation in the First Affiliated Hospital of Zhengzhou University between September 2014 and September 2016. In response to high risk factors such as spinal cord injury, massive hemorrhage, tumor cell planting and metastasis and infection as seen in the operation, nursing interventions included protecting spinal cord function, intraoperative blood pressure control, strict surgical isolation techniques, and soaking surgery field with distilled water and diluted povidone-iodine solution. Results The operation for the 6 patients were completed successfully, and all patients recovered well, without any complication such as iatrogenic spinal cord injury, important blood vessel injury or infection. It was found in the 12 to 36-month follow-up visits that the efficacy was satisfying, without local neoplasm recurrence. Conclusions Proper warning and nursing interventions against intraoperative risks make significant contributions to the smooth operation of spinal tumor patients during TES and reduce the incidence of complications effectively. Key words: Intraoperative nursing; Spinal neoplasm; Total en bloc spondylectomy; Risk warning; Nursing countermeasure