Surgical Treatment of Primary Spinal Tumors: Tactics and Results

Abstract

Objective.To study the efficacy of differentiated surgical treatment for primary spinal neoplasms based on estimation of clinical condition of a patient, survival rate, and early postoperative complications. Material and Methods. Surgery was performed in 55 out of 68 patients with primary spinal tumors involved in the study. The primary examination included CT and MRI study of the affected area of the spine. In some cases, a biopsy was performed. Results. According to histological structure, spinal tumors were identified as aggressive hemangioma, chondrosarcoma, aneuyrismal bone cyst, plasmocytoma, chordoma, giant-cell tumor, or eosinophilic granuloma. Neurological status was characterized by local pain in 18 (38 %), and by pain combined with nerve conduction disorders in 20 (40 %) patients. In accordance with the spine instability neoplastic score (SINS), most patients had stable destructions of vertebra. Evaluation of neurological status did not reveal severe deficiency: 65 % of patients had grade D or E on Frankel scale. Conclusion. Patients with tumors of the spine require careful choice of a multidisciplinary treatment. Increasing the life expectancy of patients with malignant tumors and improving the quality of life in patients with tumors of different histological structure are decisive factors in the choice of tactics and dictate the variability of approaches to treatment.Please cite this paper as: Gushcha AO, Konovalov NA, Arestov SO, Kashcheev AA, Dreval MD. Surgical treatment of primary spinal tumors: tactics and results. Hir.

Laminoplasty and Corpectomy in the Treatment of Cervical Spondylotic Myelopathy

“…7 When it comes to choosing surgical treatment for extended cervical stenosis, surgeons are guided by the following rules: maximum decompression of the spinal cord and nerve roots with maximum preservation or reconstruction of the vertebral column, minimization of postoperative complications, and the shortest possible hospitalization time. [8][9][10][11] There are several surgical techniques for managing this pathology, most of which are performed via the anterior and posterior approaches. Despite their great popularity among neurosurgeons and orthopedists, anterior surgical approaches have several disadvantages (risk of recurrent laryngeal nerve and esophagus injury, pseudoarthrosis formation, adjacent level disease etc.).…”

“…The mastery and popularization of laminoplasty techniques, and their active introduction into the practice of cervical stenosis treatment, will significantly increase the efficiency of surgery and reduce intraoperative trauma. [9][10][11][12]14 Objective: To assess the possibilities of laminoplasty surgery techniques and develop surgery tactics in patients with extended spondylogenic cervical stenosis complicated by myelopathy.…”