Primary Tumors of the Spine

Flemming, Donald J.; Murphey, Mark D.; Carmichael, Brett; Bernard, Stephanie A.

doi:10.1055/s-2000-9340

Cited by 59 publications

(47 citation statements)

References 89 publications

(184 reference statements)

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“…Primary tumors of the spine are relatively infrequent lesions compared with metastatic disease, multiple myeloma and lymphoma [10]. Their presentation is variable and insidious before the signs of spinal cord compression are detected, at which point the diagnosis becomes obvious.…”

Section: Discussionmentioning

confidence: 99%

Primary liposarcoma of the thoracic spine: case report

et al. 2005

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Section: Discussionmentioning

confidence: 99%

Primary liposarcoma of the thoracic spine: case report

et al. 2005

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“…Studies report 5-year survival rates of between 45% and 77% and 10-year survival rates between 28% and 60%. 20,[32][33][34][35][36] …”

Section: Surgical Pearlsmentioning

confidence: 99%

Image-guided resection of aggressive sacral tumors

Drazin¹,

Bhamb

Al-Khouja³

et al. 2017

FOC

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OBJECTIVE The aim of this study was to identify and discuss operative nuances utilizing image guidance in the surgical management of aggressive sacral tumors. METHODS The authors report on their single-institution, multi-surgeon, retrospective case series involving patients with pathology-proven aggressive sacral tumors treated between 2009 and 2016. They also reviewed the literature to identify articles related to aggressive sacral tumors, their diagnosis, and their surgical treatment and discuss the results together with their own experience. Information, including background, imaging, treatment, and surgical pearls, is organized by tumor type. RESULTS Review of the institutional records identified 6 patients with sacral tumors who underwent surgery between 2009 and 2016. All 6 patients were treated with image-guided surgery using cone-beam CT technology (O-arm). The surgical technique used is described in detail, and 2 illustrative cases are presented. From the literature, the authors compiled information about chordomas, chondrosarcomas, giant cell tumors, and osteosarcomas and organized it by tumor type, providing a detailed discussion of background, imaging, and treatment as well as surgical pearls for each tumor type. CONCLUSIONS Aggressive sacral tumors can be an extremely difficult challenge for both the patient and the treating physician. The selected surgical intervention varies depending on the type of tumor, size, and location. Surgery can have profound risks including neural compression, lumbopelvic instability, and suboptimal oncological resection. Focusing on the operative nuances for each type can help prevent many of these complications. Anecdotal evidence is provided that utilization of image-guided surgery to aid in tumor resection at our institution has helped reduce blood loss and the local recurrence rate while preserving function in both malignant and aggressive benign tumors affecting the sacrum.

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“…Epidural extension of a hemangioma may produce symptoms of cord compression; 90% of cases of this complication occur in the thoracic spine (36). The onset is usually insidious, with progressive pain and neurologic deficits over weeks to months.…”

Section: Hemangiomamentioning

confidence: 99%

“…These are extremely common lesions, reported in 10%-12% of spines at autopsy, and are usually an incidental finding (36). Symptomatic hemangiomas are due to bone expansion, epidural extension of the tumor, epidural hemorrhage, or vertebral body compression fracture (37).…”

Section: Hemangiomamentioning

confidence: 99%