Epidemiology and national trends in prevalence and surgical management of metastatic spinal disease

Horn, Samantha R.; Dhillon, Ekamjeet S.; Poorman, Gregory W.; Tishelman, Jared C.; Segreto, Frank A.; Bortz, Cole; Moon, John Y.; Behery, Omar A.; Shepard, Nicholas; Diebo, Bassel G.; Vira, Shaleen; Passias, Peter G.

doi:10.1016/j.jocn.2018.04.022

Cited by 29 publications

(17 citation statements)

References 23 publications

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“…The most common surgical techniques in this population include laminectomy for spinal cord decompression, resection of metastatic intraspinal tumors to prevent neurological compromise, or removal of epidural disease to allow radiotherapy. Surgery frequently requires posterior stabilization with instrumentation to prevent instability 16 . Overall, invasive spine surgery in children poses a significant morbidity with reported complication rates at 19-21% and include spinal cord shock and nerve root damage, with an inpatient mortality rate of 3% 16,17 .…”

Section: Discussionmentioning

confidence: 99%

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Vertebroplasty as a palliative treatment option for intractable pain in pediatric patients with spinal tumors

Cardarelli-Leite

Rassekh

D'Ortenzio

et al. 2021

Preprint

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Background: Primary and secondary malignant tumors of the spine are relatively uncommon in the pediatric population but are associated with high morbidity and significantly decreased quality of life due to pain. Local management of these tumors is often challenging due to the importance of maintaining vertebral mechanical integrity as well as the spinal growth potential. Typically, surgery and/or radiation therapy have been used in the primary management of these tumors. However, treatment options become more limited when there is relapse or refractory disease, with re-resection or additional radiotherapy often not being viable therapies. The purpose of this study was to assess the feasibility of percutaneous vertebroplasty as a palliative treatment for intractable pain secondary to malignant tumors affecting the spine. Procedure: A retrospective review of all cases of vertebroplasty performed at a single institution between 2003 and 2020. Results: A total of 11 vertebral levels were treated in 3 children with relapsed cancers (two with alveolar rhabdomyosarcoma, and one with Wilms tumor). All three had clinical benefit with sustained significant improvement in their pain. Conclusions: Vertebroplasty is a currently underutilized modality that might provide excellent pain palliation in cases of relapsed cancer in the spine. Future prospective studies of its use in pediatric oncology are needed.

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Section: Discussionmentioning

confidence: 99%

“…Surgery frequently requires posterior stabilization with instrumentation to prevent instability 16 . Overall, invasive spine surgery in children poses a significant morbidity with reported complication rates at 19-21% and include spinal cord shock and nerve root damage, with an inpatient mortality rate of 3% 16,17 .…”

Section: Discussionmentioning

confidence: 99%

Vertebroplasty as a palliative treatment option for intractable pain in pediatric patients with spinal tumors

Cardarelli-Leite

Rassekh

D'Ortenzio

et al. 2021

Preprint

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“…Currently, better surgical treatment for spinal metastasis has been triggered by improved surgical techniques. [26] We intend to use the surgical interventions to relieve pain, reduce local tumor, stabilize spine, and preserve the neurological function. Molina et al has indicated that the survival rates for patients with spinal metastasis were improved with progressive surgical techniques.…”

Section: Discussionmentioning

confidence: 99%

Malignant melanoma with indiscoverable skin manifestations presenting with paresis and refractory hypercalcemia

et al. 2019

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Rationale: Malignant melanoma with indiscoverable skin manifestations is unusual and refractory hypercalcemia with high metabolic signal of the rectum as initial manifestation is very rare. Patient concerns: We present a case that presented with paresis, nausea, and vomiting. Diagnoses: Malignant melanoma with spinal metastasis. Interventions and outcomes: The patient underwent posterior decompression, partial tumor resection, bone cement reconstruction, and internal fixation. The patient's hypercalcemia was controlled and muscle strength was partially recovered. The immunohistochemical stainings showed Melan-A (+), HMB45 (+), s-100 (+), Vimentin (+), and AE1/AE3 (−). Lessons: We emphasize the necessity of screening potential existence of neoplasms for the patients with hypercalcemia. Surgical treatment is still necessary for patients with spinal metastasis.

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“…Radical treatment of BM is challenging and often requires an integrated multidisciplinary approach [18][19][20][21]. Surgery and RT have traditionally been the treatment of choice in such a clinical scenario.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous image-guided ablation of bone metastases: local tumor control in oligometastatic patients

Cazzato

Auloge

Marini

et al. 2018

International Journal of Hyperthermia

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Introduction: Percutaneous image-guided cryo-(CA) and radiofrequency-(RFA) ablations have been widely used in the treatment of painful bone metastases (BM). However, paucity of data is available for the performance of these treatments when used with a curative intent. The aim of this study is to investigate the local progression free-survival (LPFS) after radical percutaneous image-guided ablation of BM in oligometastatic patients, and to identify predictive factors associated with local tumor progression. Materials and Methods: This is a retrospective review of all patients who underwent percutaneous image-guided CA or RFA of BM with a radical intent between 2007 and 2018. Results: Forty-six patients with a total of forty-nine BM underwent percutaneous image-guided CA (N ¼ 37; 75,5%) or RFA (N ¼ 12; 24,5%). Primary malignancies included thyroid (N ¼ 11, 22.5%), breast (N ¼ 21; 42.9%), lung (N ¼ 8; 16.3%) and other (N ¼ 9; 18,3%) cancers. Additional consolidation was performed after ablation in 20.4% cases (N ¼ 10). Mean follow-up was 34.1 ± 22 months. Local progression at the treated site was observed in 28.5% cases (N ¼ 14); 1-and 2-year LPFS was 76.8% and 71.7%, respectively. Size of BM (>2 cm) predicted local tumor progression (p ¼ .002). Conclusions: Percutaneous image-guided locoregional therapies used in the radical treatment of BM in oligometastatic patients demonstrate significant rates of LPFS providing the size of BM 2 cm.

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Epidemiology and national trends in prevalence and surgical management of metastatic spinal disease

Cited by 29 publications

References 23 publications

Vertebroplasty as a palliative treatment option for intractable pain in pediatric patients with spinal tumors

Vertebroplasty as a palliative treatment option for intractable pain in pediatric patients with spinal tumors

Malignant melanoma with indiscoverable skin manifestations presenting with paresis and refractory hypercalcemia

Percutaneous image-guided ablation of bone metastases: local tumor control in oligometastatic patients

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