Coaxial double-lumen methylmethacrylate reconstruction in the anterior cervical and upper thoracic spine after tumor resection

Miller, Daniel J.; Lang, Frederick F.; Walsh, Garrett L.; Abi-Said, Dima; Wildrick, David M.; Gokaslan, Ziya L.

doi:10.3171/spi.2000.92.2.0181

Cited by 33 publications

(30 citation statements)

References 52 publications

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“…Treatment of metastatic spinal lesions with vertebrectomy and stabilization has been shown to provide significant and sustained improvement in pain control (Table 8) [4,5,20,24,25,35,37,47,50,52]. Similar pain relief was achieved in our series, as evidenced by decreases in VAS and pain medication scale scores that lasted for at least 1 year.…”

Section: Indications For Surgerysupporting

confidence: 72%

“…Extensive tumors involving both the anterior and posterior aspects of the spine were approached and stabilized either from both anterior and posterior or by using a lone posterior transpedicular vertebrectomy technique as previously described [1]. In the cervical and upper thoracic spine, anterior stabilization was achieved by using the coaxial double-lumen methylmethacrylate technique (with anterior plating) as previously described [35]. Anterior stabilization of the mid-and lower thoracic and lumbar spine was achieved by using methylmethacrylate or titanium spacers with an anterolateral plate.…”

Section: Perioperative Data and Surgical Approachmentioning

confidence: 99%

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Surgical treatment strategies and outcome in patients with breast cancer metastatic to the spine: a review of 87 patients

et al. 2007

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Aggressive surgical management of spinal metastatic disease can provide improvement of neurological function and significant pain relief. However, there is limited literature analyzing such management as is pertains to individual histopathology of the primary tumor, which may be linked to overall prognosis for the patient. In this study, clinical outcomes were reviewed for patients undergoing spinal surgery for metastatic breast cancer. Respective review was done to identify all patients with breast cancer over an eight-year period at a major cancer center and then to select those with symptomatic spinal metastatic disease who underwent spinal surgery. Pre-and postoperative pain levels (visual analog scale [VAS]), analgesic medication usage, and modifed Frankel grade scores were compared on all patients who underwent surgery. Univariate and multivariate analyses were used to assess risks for complications. A total of 16,977 patients were diagnosed with breast cancer, and 479 patients (2.8%) were diagnosed with spinal metastases from breast cancer. Of these patients, 87 patients (18%) underwent 125 spinal surgeries. Of the 76 patients (87%) who were ambulatory preoperatively, the majority (98%) were still ambulatory.Of the 11 patients (13%) who were nonambulatory preoperatively, four patients were alive at 3 months postoperatively, three of which (75%) regained ambulation. The preoperative median VAS of six was significantly reduced to a median score of two at the time of discharge and at 3, 6, and 12 months postoperatively (P < 0.001 for all time points). A total of 39% of patients experienced complications; 87% were early (within 30 days of surgery), and 13% were late. Early major surgical complications were significantly greater when five or more levels were instrumented. In patients with spinal metastases specifically from breast cancer, aggressive surgical management provides significant pain relief and preservation or improvement of neurological function with an acceptably low rate of complications.

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Section: Indications For Surgerysupporting

confidence: 72%

Section: Perioperative Data and Surgical Approachmentioning

confidence: 99%

Surgical treatment strategies and outcome in patients with breast cancer metastatic to the spine: a review of 87 patients

et al. 2007

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“…For this reason, aggressive surgical intervention is often considered in patients with metastatic spine disease who can tolerate surgery [5,19,24,33,38,39,47,48,53,54]. Recently, Ogihara et al [36] reviewed patients with lung cancer metastatic to the spine in attempt to identify prognostic factors that may aid in stratifying patients towards medical or surgical treatment.…”

Section: Indications For Surgerymentioning

confidence: 99%

Positive and negative prognostic variables for patients undergoing spine surgery for metastatic breast disease

et al. 2007

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The histology of the primary tumor in metastatic spine disease plays an important role in its treatment and prognosis. However, there is paucity in the literature of histology-specific analysis of spinal metastases. In this study, prognostic variables were reviewed for patients who underwent surgery for breast metastases to the spinal column. Respective chart review was done to first identify all patients with breast cancer over an 8-year period at a major cancer center and then to select all those with symptomatic metastatic disease to the spine who underwent spinal surgery. Univariate and multivariate analyses were used to assess several prognostic variables. Presence of visceral metastases, multiplicity of bony lesions, presence of estrogen receptors (ER), and segment of spine (cervical, thoracic, lumbar, sacral) in which metastases arose were compared with patient survival. Eighty-seven patients underwent 125 spinal surgeries. Those with estrogen receptor (ER) positivity had a longer median survival after surgery compared to those with estrogen receptor negativity. Patients with cervical location of metastasis had a shorter median survival compared with those having metastases in other areas of the spine. The presence of visceral metastases or a multiplicity of bony lesions did not have prognostic value. In patients with spinal metastases from breast cancer, aggressive surgical management may be an option for providing significant pain relief and preservation/improvement of neurological function. Interestingly, in patients undergoing such surgery, cervical location of metastasis is a negative prognostic variable, and ER-positivity is associated with better survival, while presence of visceral or multiple bony lesions does not significantly alter survival.

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“…Anterior stabilization of the cervical and upper thoracic spine was achieved using the polymethylmethacrylate (PMMA) technique along with anterior plating, as previously described. 22 Anterior stabilization of the mid-and lower thoracic spine or the lumbar spine was achieved using PMMA or expandable titanium cages along with anterolateral plating.…”

Section: Surgical Approachmentioning

confidence: 99%

Factors affecting survival in 43 consecutive patients after surgery for spinal metastases from thyroid carcinoma

Sellin

Suki

Harsh

et al. 2015

SPI

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OBJECT Spinal metastases account for the majority of bone metastases from thyroid cancer. The objective of the current study was to analyze a series of consecutive patients undergoing spinal surgery for thyroid cancer metastases in order to identify factors that influence overall survival. METHODS The authors retrospectively reviewed the records of all patients who underwent surgery for spinal metastases from thyroid cancer between 1993 and 2010 at the University of Texas MD Anderson Cancer Center. RESULTS Forty-three patients met the study criteria. Median overall survival was 15.4 months (95% CI 2.8–27.9 months) based on the Kaplan-Meier method. The median follow-up duration for the 4 patients who were alive at the end of the study was 39.4 months (range 1.7–62.6 months). On the multivariate Cox analysis, progressive systemic disease at spine surgery and postoperative complications were associated with worse overall survival (HR 8.98 [95% CI 3.46–23.30], p < 0.001; and HR 2.86 [95% CI 1.30–6.31], p = 0.009, respectively). Additionally, preoperative neurological deficit was significantly associated with worse overall survival on the multivariate analysis (HR 3.01 [95% CI 1.34–6.79], p = 0.008). Conversely, preoperative embolization was significantly associated with improved overall survival on the multivariate analysis (HR 0.43 [95% CI 0.20–0.94], p = 0.04). Preoperative embolization and longer posterior construct length were significantly associated with fewer and greater complications, respectively, on the univariate analysis (OR 0.24 [95% CI 0.06–0.93] p = 0.04; and OR 1.24 [95% CI 1.02–1.52], p = 0.03), but not the multivariate analysis. CONCLUSIONS Progressive systemic disease, postoperative complications, and preoperative neurological deficits were significantly associated with worse overall survival, while preoperative spinal embolization was associated with improved overall survival. These factors should be taken into consideration when considering such patients for surgery. Preoperative embolization and posterior construct length significantly influenced the incidence of postoperative complications only on the univariate analysis.

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Coaxial double-lumen methylmethacrylate reconstruction in the anterior cervical and upper thoracic spine after tumor resection

Cited by 33 publications

References 52 publications

Surgical treatment strategies and outcome in patients with breast cancer metastatic to the spine: a review of 87 patients

Surgical treatment strategies and outcome in patients with breast cancer metastatic to the spine: a review of 87 patients

Positive and negative prognostic variables for patients undergoing spine surgery for metastatic breast disease

Factors affecting survival in 43 consecutive patients after surgery for spinal metastases from thyroid carcinoma

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