Computed Tomographically Guided Biopsy of the Spine

Babu, Narayanam Surendra; Titus, V. T. K.; Chittaranjan, Samuel; Abraham, George P.; Prem, Hari; Korula, Roy John

doi:10.1097/00007632-199411000-00013

Cited by 77 publications

(42 citation statements)

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“…More recently, trans-pedicular and trans-costovertebral approaches have been described [1,[3][4][5][6]9]. CT guidance has been described as safer than fluoroscopic guidance [10]; however, a recent meta-analysis has suggested no significant difference in complication rates (3.3-5.3%) [7].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous approach to the upper thoracic spine: optimal patient positioning

2009

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Section: Discussionmentioning

confidence: 99%

Percutaneous approach to the upper thoracic spine: optimal patient positioning

2009

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“…Nevertheless, in cases when biopsy specimens are inadequate or indeterminate [29], open biopsy would remain the method of choice. Generally, the surgeon who performs the definitive tumour resection should perform or direct the biopsy procedure.…”

Section: Biopsymentioning

confidence: 99%

“…Generally, the surgeon who performs the definitive tumour resection should perform or direct the biopsy procedure. Poorly planned incisional biopsies or incomplete debulking operations performed prior to referral to a spinal oncology centre have been shown to increase the risk of local recurrence and metastasis [29][30][31].…”

Section: Biopsymentioning

confidence: 99%

“…Local pain may present due to the periosteal stretching from the tumour growth and/or the local inflammatory process or mechanically as a result of instability. Radicular pain from irritation of a nerve root [9,10,[29][30][31] occurs due to nerve root compression or even tumour infiltration. Radicular pain may radiate uni-or bilaterally into buttocks, posterior thigh or leg, external genitalia and perineum [45][46][47].…”

Section: Clinical Presentationmentioning

confidence: 99%

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Management of metastatic sacral tumours

et al. 2012

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Purpose Metastatic involvement of the sacrum is rare and there is a paucity of studies which deal with the management of these tumours since most papers refer to primary sacral tumours. This study aims to review the available literature in the management of sacral metastatic tumours as reflected in the current literature. Methods A systematic review of the English language literature was undertaken for relevant articles published over the last 11 years (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010). The PubMed electronic database and reference lists of key articles were searched to identify relevant studies using the terms ''sacral metastases'' and ''metastatic sacral tumours''. Studies involving primary sacral tumours only were excluded. For the assessment of the level of evidence quality, the CEBM (Oxford Centre of Evidence Based Medicine) grading system was utilised. Results The initial search revealed 479 articles. After screening, 16 articles identified meeting our inclusion criteria [1 prospective cohort study on radiosurgery (level II); 2 case series (level III); 4 retrospective case series (level IV) and 9 case reports (level IV)]. Conclusion The mainstay of management for sacral metastatic tumours is palliation. Preoperative angioembolisation is shown to be of value in cases of highly vascularised tumours. Radiotherapy is used as the primary treatment in cases of inoperable tumours without spinal instability where pain relief and neurological improvement are attainable. Minimal invasive procedures such as sacroplasties were shown to offer immediate pain relief and improvement with ambulation, whereas more aggressive surgery, involving decompression and sacral reconstruction, is utilised mainly for the treatment of local advanced tumours which compromise the stability of the spine or threaten neurological status. Adjuvant cryosurgery and radiosurgery have demonstrated promising results (if no neurological compromise or instability) with local disease control.

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“…Reconstruction of the extensor mechanism using the medial gastrocnemius muscle has been previously described for combined tissue loss during revision knee arthroplasty or tumour surgery [5,15,20,26,27], but few prior reports describe its use as a post-traumatic reconstructive option [3,7,16,23].…”

Section: Introductionmentioning

confidence: 99%