An evaluation of surgical treatment for spinal cord compression due to metastatic carcinoma

Smith, Roderick

doi:10.1136/jnnp.28.2.152

Cited by 58 publications

(18 citation statements)

References 18 publications

(18 reference statements)

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“…In our series, this occurred in 60% of the cases, with a statistically significant difference (p < 0.05) with respect to the frequency of cervical and lumbar localizations. This predominance of the thoracic localization is similar to that reflected in other series30, 35,40 (Fig. 4).…”

Section: Discussionsupporting

confidence: 87%

Utility of surgery in the treatment of epidural vertebral metastases

et al. 1990

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Treatment of vertebral epidural metastases has been in the past and still remains the object of special attention in an attempt to improve the quality of life of these patients. To assess the effects of and indications for surgery, the clinical histories of 53 patients with this malignant disease who had undergone decompressive laminectomy have been reviewed retrospectively. The importance of the presence of complete or partial spinal cord compression in correlation with the presence of complete or partial myelographic block is dealt with. The results concerning pain, gait disturbances and sphincter disorders are studied with respect to the clinical and myelographic picture for the purpose of establishing the indications for decompressive laminectomy. Pain is not an indication for operative decompression, and complete paraplegia always never improves, thus being a contraindication. But in incomplete spinal cord involvement a decompression operation may be followed by an improvement of neurological deficit and quality of life.

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Section: Discussionsupporting

confidence: 87%

Utility of surgery in the treatment of epidural vertebral metastases

et al. 1990

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“…Thirteen other patients suffered some postoperative complications, including epidural hemorrhage in 2, instability with subluxation of the spine in 4, wound infection in 4, and wound dehiscence or delayed closure in 3. 8 (22) 4 (13) 11 (29) 28 (33) 44 (32) 13 (25) 13 (38) 15 (37) 20 (39) 62 (38) 20 (31) 78 (35) 17 (50) 39 (30) 7 (27) 55 (61) 29 (45) . .…”

Section: Post -0pmentioning

confidence: 97%

Epidural spinal cord compression from metastatic tumor: Diagnosis and treatment

Gilbert

Kim

Posner

1978

Annals of Neurology

886

360

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The clinical findings in 130 conseucutive cases of spinal cord compression by metastatic extradural tumors were analyzed. These 130 patients were combined with a previous survey of 105 patients to compare the effectiveness of radiation therapy (RT) alone with that of surgical decompression followed by RT. Ambulation after treatment was considered a successful outcome. The most common primary tumors producing spinal cord compression were (in order) breast, lung, prostate, and kidney. In 68% of these tumors the thoracic region was involved. Pain was the primary symptom of 96% of the patients, while motor or sensory deficits (or both) were found in 82% of them. Therapy consisted of surgery and RT in 65 patients and RT alone in 170 patients. There were no differences in outcome between those treated by surgery combined with RT and those managed by RT alone. Patients with radiosensitive tumors and those ambulatory at the onset of treatment benefited whether treated by surgery or by RT. Seventy-five percent of living patients who improved from treatment remained ambulatory at 6 months, and approximately 50% of living patients were ambulatory at 1 year. We conclude that RT without decompressive laminectomy is as effective as decompressive laminectomy in treating epidural spinal cord compression from systemic cancer.

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“…On the other hand, there has been an observed propensity towards a particular spinal level of compression and the site of the primary lesion, such as colon or prostatic cancer metastasizing more frequently to the lumbosacral spine than carcinoma at other sites; bronchogenic or breast carcinoma, to the thoracic spine [2,6]. An additional observation by some authors [2,19,23] confirmed in this series, was that the duration or period of progression of symptomatology was relatively swifter in bronchogenic carcinoma than that from another site of primary malignancy.…”

Section: Discussionmentioning

confidence: 95%

Epidural compression from metastatic tumor with resultant paralysis

Ampil

1989

J Neuro-Oncol

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To determine the value of the usually given 'urgent' palliative radiotherapy in paraplegic patients with epidural compression from metastatic tumor, 20 consecutive cases treated between 1981 and 1986 were retrospectively analyzed. Bronchogenic and prostatic carcinoma were the more common extraspinal sources of metastasis. Epidural metastasis involved the thoracic spine in most cases. The onset of neurological symptomatology was frequently within two weeks prior to hospitalization. The majority of the subjects received at least 3000 cGy given in 10 to 15 fractions. Symptomatic (pain relief) response rate was 78 (7/9) percent. The observed period of survival averaged 2.5 months after treatment. This study reaffirmed the little chance for recovery of lost limb(s0 motor function. None of the patients (most of whom were paraplegic from two to 90 days pre-irradiation) became ambulatory including the two in whom irradiation was administered within 24 hours from the onset of paraplegia.

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An evaluation of surgical treatment for spinal cord compression due to metastatic carcinoma

Cited by 58 publications

References 18 publications

Utility of surgery in the treatment of epidural vertebral metastases

Utility of surgery in the treatment of epidural vertebral metastases

Epidural spinal cord compression from metastatic tumor: Diagnosis and treatment

Epidural compression from metastatic tumor with resultant paralysis

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