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Study Design: Retrospective analysis.Objective: To investigate (1) whether resection of primary tumor improves survival of metastatic spinal chondrosarcoma patients and (2) which subgroups of metastatic spinal chondrosarcoma patients benefit more from primary tumor resection.Summary Of Background Data: Surgical resection is the mainstay of treatment for spinal chondrosarcoma, as chondrosarcoma is inherently resistant to radiotherapy and chemotherapy. However, evidence which justifies resection of the primary tumor for patients with metastatic spinal chondrosarcoma is still lacking.Methods: We retrospectively included 110 patients with metastatic spinal chondrosarcoma in the Surveillance, Epidemiology, and End Results database from 1983 to 2016. The association between primary tumor resection and survival was evaluated using Kaplan-Meier analyses, log-rank tests, and multivariable Cox analyses. The effect of primary tumor resection on survival was further assessed in subgroups stratified by histologic subtype, tumor grade, and age.Results: Overall, 110 patients were divided into surgery group (n = 55, 50%) and nonsurgery group (n = 55, 50%). Primary tumor resection was associated with both prolonged overall survival (hazard ratio 0.262, 95% confidence interval 0.149-0.462, P < 0.001) and cancer-specific survival (hazard ratio 0.228, 95% confidence interval 0.127-0.409, P < 0.001). When we focused on surgical effects in subgroups, primary tumor resection conferred survival advantage on patients with conventional subtype, grade I to III malignancy, and an age younger than 70 years old (P < 0.001 for overall and cancer-specific survival). However, primary tumor resection brought limited survival benefit for patients with dedifferentiated subtype and patients over 70 years old.Conclusion: The present population-based study for the first time reports a clear association between primary tumor resection and prolonged survival in metastatic spinal chondrosarcoma patients. Specifically, primary tumor resection was associated with improved survival in patients with conventional subtype, grade I to III malignancy, and an age younger than 70 years old.Level Of Evidence: 4. [ABSTRACT FROM AUTHOR]

Study Design: A retrospective clinical and radiographic study.Objective: The aim of this study was to evaluate outcomes of the key vertebral pedicle screw strategy (KVPSS) for the correction of flexible Lenke type 1 adolescent idiopathic scoliosis (AIS) with a minimum follow-up of 5 years.Summary Of Background Data: The KVPSS has been described as an alternative screw placement strategy for surgically treating the main thoracic curve in AIS patients. However, there have been no long-term, three-dimensional correction studies of selective thoracic fusion using the KVPSS in Lenke type 1AIS.Method: Twenty consecutive patients with Lenke type 1 main thoracic AIS underwent one-stage posterior correction and fusion using the KVPSS. Preoperative and postoperative radiographic and clinical parameters were analyzed.Results: The mean preoperative major thoracic curve was 47.4° ± 5.8°, and mean corrections of 67.0%, 63.4%, and 61.5% were observed at the immediate, 2-year postoperative, and final follow-ups, respectively. Thoracickyphosis decreased significantly from the preoperative period to the immediate postoperative period (P = 0.042) but did not change significantly from the 2-year postoperative follow-up to the final follow-up (P = 0.067). Apical vertebral rotation achieved 34.7% correction and exhibited correction loss of 8.2% at the final follow-up. The average intraoperative blood loss was 802.3 mL, and the mean operative time was 138.6 minutes. SRS-22 scores for self-image and satisfaction improved significantly from the preoperative period to the final follow-up. No neurologic or implant-associated complications were observed in this study.Conclusion: The KVPSS is an effective method for correcting Lenke type 1 AIS and achieves satisfactory correction of the deformity. Relative to other approaches, the KVPSS can not only achieve a satisfactory and cost-effective clinical outcome but also reduce both operative time and intraoperative blood loss.Level Of Evidence: 4. [ABSTRACT FROM AUTHOR]