Classification and scoring systems for metastatic spine tumors: a literature review

Tokuhashi, Yasuaki; Uei, Hiroshi; Oshima, Masashi

doi:10.22603/ssrr.1.2016-0021

Cited by 28 publications

(13 citation statements)

References 76 publications

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“…Also, dissemination of these cells following Valsalva maneuver through Batson plexus is documented, along with direct invasion of cancerous cells through intervertebral foramens. Nearly half of the patients diagnosed with spinal metastasis suffer from multiple vertebrae involvement and 10 to 38% endured multiple non-conjunction level involvements [11]. Most of these lesions are found in anterior vertebral body (about 60%), followed by vertebral pedicle and lamina (about 30%); however, metastatic lesions were reported in both anterior and posterior vertebral bodies.…”

Section: Discussionmentioning

confidence: 99%

First Experience of Intra-Operative Radiation Therapy (IORT) during Kyphoplasty in Patients Diagnosed with Spinal Metastasis in Iran

Seddighi¹,

Seddighi²,

Nikouei³

et al. 2021

austinjclincaserep

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Object: Based on previous studies, 30 to 40% of cancer patients are diagnosed with bone metastasis. Median Overall Survival (OS) of patients who are diagnosed with spinal metastasis (vertebral structures) is about 7 to 9 months which with recent progresses in oncologic and radiotherapy treatment modalities, their prognosis is slightly developed. In this study, authors plan to evaluate the effects of Intra-operative Radiation Therapy (IORT) in patients who are candidate for Kyphoplasty procedure. Methods: In this study, we have included patients who are diagnosed with spinal metastasis with radiological and histopathological confirmation. From July 2017 to December 2018, we have included 9 patients who fulfilled our predefined inclusion and exclusion criteria into our case-series study performed on Shohada Tajrish Hospital. Patients underwent radiotherapy during Kyphoplasty by our IORT device INTRABEAM (Carl Zeiss AG, Germany) as “Kypho-IORT’ procedure. We have evaluated these patients in post-operative period, as well as on 2 weeks, 1 month, 2 months and 6 months on post-operative period as our follow-up plan. Results: In this study, 9 patients (5 males and 4 females) with mean age of 68 years with spinal metastasis from breast (4 cases), prostate (2 cases), lung (2 cases) and gastrointestinal tract (1 case), underwent Kypho-IORT for 15 vertebrae levels with individualized radiation dose and interval. In postoperative follow-up period, patients exhibit pain relief (in 78%) assessed by Visual Assessment Score (VAS) and improvement in their Quality of Life (QoL). No major complications including new neurological deficit, major cement leak and embolic disorders were encountered during the study; however, minor cement leak encountered in 4 cases, and 2 patients have expired during follow up period; however, other patients are still alive and under follow-up with mean OS of 10 months. Conclusion: This study is the first experience of evaluation of IORT effects during Kyphoplasty in Iran, in patients diagnosed with spinal metastasis with poor prognosis, to improve their quality of life, local control rate and their OS. This study could be considered as one of the pioneers in continuing the evaluation of Kypho-IORT as a novel technique in these group of patients.

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Section: Discussionmentioning

confidence: 99%

First Experience of Intra-Operative Radiation Therapy (IORT) during Kyphoplasty in Patients Diagnosed with Spinal Metastasis in Iran

Seddighi¹,

Seddighi²,

Nikouei³

et al. 2021

austinjclincaserep

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“…However, the patient was quite satisfied with the surgery because her low back and lower extremity pain was relieved substantially. Surgical treatment may be a favorable option to improve the quality of life in such cases, even if the patient’s prognosis is not good [16].…”

Section: Discussionmentioning

confidence: 99%

Intradural metastasis to the cauda equina found as the initial presentation of breast cancer: a case report

et al. 2019

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Background Intradural extramedullary spinal metastasis is a relatively rare condition. Furthermore, there are few reports with the initial presentation being a neurological symptom from an intradural metastasis. We report a case of a patient with metastasis to the cauda equina from breast cancer found due to neurological symptoms as the initial presentation. Case presentation A 76-year-old Japanese woman who was previously healthy presented to our hospital with bilateral severe buttock and lower extremity pain without any history of injury. A solitary intradural cauda equina mass was found by magnetic resonance imaging at the L2/3 level, and we suspected a schwannoma initially. The patient hoped to undergo surgery due to the severe pain. However, the chest computed tomographic scan obtained to assess the patient’s general status showed the suspected breast cancer of the left side and a lung metastasis. Hence, we considered the possibility of cauda equina tumor metastatic from the breast cancer. We performed an L1–3 laminectomy and tumor extirpation. The pathology revealed adenocarcinoma. After surgery, she had relief from pain, and her status remained satisfactory until she died 9 months after surgery. Conclusions It is difficult to clarify whether the cauda equina tumor is benign or malignant based only on Magnetic resonance imaging findings. Clinicians should consider the possibility of metastasis when planning the surgery for intradural cauda equina tumor extirpation.

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“…Surgical intervention is indicated in patients in Class IV–V. One limitation of the Harrington classification is its lack of objectivity [ 121 ]. The degree of neurological deficit is not accounted for.…”

Section: Metastasismentioning

confidence: 99%

Characterization and Treatment of Spinal Tumors

2022

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The prevalence of spinal tumors is rare in comparison to brain tumors which encompass most central nervous system tumors. Tumors of the spine can be divided into primary and metastatic tumors with the latter being the most common presentation. Primary tumors are subdivided based on their location on the spinal column and in the spinal cord into intramedullary, intradural extramedullary, and primary bone tumors. Back pain is a common presentation in spine cancer patients; however, other radicular pain may be present. Magnetic resonance imaging (MRI) is the imaging modality of choice for intradural extramedullary and intramedullary tumors. Plain radiographs are used in the initial diagnosis of primary bone tumors while Computed tomography (CT) and MRI may often be necessary for further characterization. Complete surgical resection is the treatment of choice for spinal tumors and may be curative for well circumscribed lesions. However, intralesional resection along with adjuvant radiation and chemotherapy can be indicated for patients that would experience increased morbidity from damage to nearby neurological structures caused by resection with wide margins. Even with the current treatment options, the prognosis for aggressive spinal cancer remains poor. Advances in novel treatments including molecular targeting, immunotherapy and stem cell therapy provide the potential for greater control of malignant and metastatic tumors of the spine.

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Classification and scoring systems for metastatic spine tumors: a literature review

Cited by 28 publications

References 76 publications

First Experience of Intra-Operative Radiation Therapy (IORT) during Kyphoplasty in Patients Diagnosed with Spinal Metastasis in Iran

First Experience of Intra-Operative Radiation Therapy (IORT) during Kyphoplasty in Patients Diagnosed with Spinal Metastasis in Iran

Intradural metastasis to the cauda equina found as the initial presentation of breast cancer: a case report

Characterization and Treatment of Spinal Tumors

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