Spinal Tumor Resection with Intraoperative Computed Tomography Navigation in Tumor-Induced Osteomalacia: A Case Report

Review Data

Q: Is the topic relevant to the journal area of interest? Is it contemporary and interesting for

researchers?

A: Good

Abstract & Keywords

Q: Are all required components included in the abstract? Are the keywords appropriately chosen?

A: Good

Goal

Q: Is the goal explicitly stated in the Introduction? Is its formulation clear and unambiguous?

A: Good

Structure

Q: Is the paper's structure coherent? Is it in coherence with the goal of the paper?

A: Good

Comments: The subheadings Introduction, Case Report and Discussion have been introduced wherever appropriate.

Tools and Methods

Q: Are methods the author uses adequate and well used?

A: Good

Discussion & Conclusion

Q: Is it related to the results presented before? Do you consider them as coherent?

A: Good

Comments: The Discussion establishes that the case of tumor-induced osteomalacia (TIO) reported in this study is rare and has high refractory risk. The tumor resection guided by intraoperative computed tomography (CT) navigation enabled the accurate localization of the tumor and guidance in the resection area and ensured the complete resection of the tumor with wide margins without any complications. Relevant literature has been cited to support the discussion. The study concludes that treating patients, who have TIO located at the thoracic vertebrae, with an intraoperative CT navigation guided tumor resecting surgery can be safe and effective.

Literature

Q: Does the author utilize relevant literature?

A: Good

Author's knowledge

Q: What is the level of the author’s knowledge? Does the author utilize all recent contributions relevant to the topic?

A: Good

Length

Q: Is the length of the paper adequate to the significance of the topic? Do you suggest shortening the paper without losing its value?

A: Good

Figures & Tables

Q: Does the author use them suitably? Are legend and notations clear?

A: Good

Comments: The 2^nd sentence in the figure legend of Figure 1 was not making sense. So, the “0” was removed from the sentence.

Writing style

Q: Is it clear and understandable?

A: Good

Comments: Except the following errors were detected:

1.     The 2^nd sentence under the Abstract was not making sense and should be changed to “TIO …… caused by Fibroblast growth factor 23 secreted by tumor tissue.”

2.     The 4^th sentence under the Abstract was not framed properly and should be changed to “However, the….is hard to find it, and it tends to be seen when the recurrence is caused by the difficulty of whole tumor resection.”

3.     The word “rare” has been misspelled in the text part of the manuscript.

Further comments on the paper

Comments: The case report presents the rare case of a 57-year-old woman with tumor-induced osteomalacia (TIO) located in the T10 vertebra body, who had a history of multiple rib fractures and back and buttock pain. This is a first of its kind study which reports navigation-assisted tumor resecting surgery in patients with TIO located at the thoracic vertebrae. TIO is a rare paraneoplastic syndrome. Intraoperative computed tomography (CT)-guided navigation was used to resect the tumor at the T10 vertebra precisely and safely. The study highlights the CT navigation was useful for the accurate localization of the tumor, the guidance of resection area and confirmation for excision of tumor. 3 days postoperative CT images confirmed the complete tumor removal with adequate resection margins and a 1-year postoperative follow-up showed the clinical course of the patient was good. The study concludes that the TIO lesions of the spine, which is small and difficult and dangerous to access, can be treated safely with intraoperative computed tomography navigation guided tumor resection.

Q: Would you recommend this manuscript for further publication?

A: Yes - Suitable to be published

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Science Repository Team