Surgery of cervical spine metastases: A retrospective study

Abstract

Fifty-one consecutive patients with metastatic lesions of the cervical spine were treated surgically. The most common primary tumor types were breast cancer and myeloma. In 14 (27%) patients, the cervical lesion was the first manifestation of the malignancy. All patients suffered from severe pain but only six had long tract symptoms. Five tetraparetic patients were confined to bed. Vertebral body collapse occurred in 73% of cases. The surgical technique was individualized according to the patient's general condition, the site of metastasis on the vertebra, and the level and number of levels bearing in mind that the treatment is palliative in nature. The goal of treatment was a better quality of life. In the upper cervical spine the technique described by Sjöström et al. was used, if technically possible. If the odontoid process had been totally destroyed, an occipitocervical stabilization was chosen. In the lower cervical spine, an anterior approach was used to resect the tumor growth. Anterior support was provided with bone cement if the patient was not expected to survive long; otherwise bone grafting was used. In cases with two or more levels of involvement, a combined anteroposterior stabilization was usually performed. Good pain relief was achieved postoperatively. The operation was generally well-tolerated by the patients, mild dysphagia being the most common complaint. One patient died 2 days postoperatively of heart failure, giving a postoperative mortality of 2%. Rhizopathy symptoms were relieved totally in 15 patients and partially in 6.(ABSTRACT TRUNCATED AT 250 WORDS)

Preliminary experience of titanium mesh cages for pathological fracture of middle and lower cervical vertebrae

“…[4][5][6]15,[17][18][19] The surgical procedure of choice for treating occipital cervical metastases or C1-2 spinal metastases involves the posterior approach, with resection of the tumor and performance of posterior lateral fixation and fusion. 18,20 In contrast, for patients with middle or lower cervical vertebral metastases, anterior cervical corpectomy and interbody fusion are considered the procedures of choice. These procedures can provide immediate decompression and spinal stability without associated morbidities.…”

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

“…The median survival time for the entire group was approximately 9 months, which is consistent with the data in the literature. 2,6,30,40 Various techniques have been described in the literature for reconstruction of the cervical and cervicothoracic spine following corpectomy. 3,6,7,9,11,13,24,32,36,40,42,48,49 In patients with degenerative spinal disease, autologous bone (commonly harvested from the iliac crest) or bone allograft has been a well-accepted replacement material for use after vertebral body removal, with or without additional placement of a plate fixation system.…”

Percutaneous Vertebroplasty Relieves Pain in Metastatic Cervical Fractures

“…Patients in Class 3 are initially treated with radiotherapy alone, but similar to those in Classes 4 and 5, they do not always respond [27]. Furthermore, life expectancy is an important factor to justify surgical treatment, and generally, indications include a life expectancy of greater than 6 months and isolated metastasis [3,13,18,20]. Radiation therapy provides local pain control in a high percentage of cases and works best if combined with chemotherapy.…”