Neuroimaging of spine tumors

Pintér, Nándor; Pfiffner, Thomas J.; Mechtler, Laszlo

doi:10.1016/b978-0-444-53486-6.00033-8

Cited by 23 publications

(29 citation statements)

References 54 publications

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“…(Table ) In MRI, malignant vertebral tumors demonstrate low‐signal intensity in T1‐weighted images, high‐signal intensity in T2‐weighted images, and clear enhancement with gadolinium contrast medium, which reflects hypervascularity in the tumor. Morphologically, various patterns can be seen such as irregularities of the tumor margin, irregularities of the internal structures reflecting necrotic tissues, and extraosseous extension of tumor lesion . CT scans usually reveal osteolysis or osteosclerosis in the malignant vertebral tumors .…”

Section: Discussionmentioning

confidence: 99%

“…Morphologically, various patterns can be seen such as irregularities of the tumor margin, irregularities of the internal structures reflecting necrotic tissues, and extraosseous extension of tumor lesion . CT scans usually reveal osteolysis or osteosclerosis in the malignant vertebral tumors . Hemangioma, a common benign vertebral tumor, demonstrates high‐signal intensities in T1‐ and T2‐weighted images, remarkable enhancement on MRI, and a typical “polka‐dot sign” on CT, indicating thickened trabeculae in the vertebral body .…”

Section: Discussionmentioning

confidence: 99%

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Diagnosis of benign notochordal cell tumor of the spine: is a biopsy necessary?

Tateda

Hashimoto

Aizawa

et al. 2017

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diagnosis of benign notochordal cell tumor of the spine: is a biopsy necessary?

Tateda

Hashimoto

Aizawa

et al. 2017

Clinical Case Reports

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“…Spinal cord compression develops in 10–20% of patients with spinal disease and in 5–10% of all cancer patients (4). While pain is the most frequent symptom, 10% of cancer patients develop weakness, sensory disturbances, bowel or bladder dysfunction, and gait disturbance from instability or spinal cord compression (5, 6). In a study of over 15,000 patients with metastatic spinal cord compression, the most common histologies were lung cancer (25%), prostate cancer (16%), and multiple myeloma (11%) (7, 8).…”

Section: Introductionmentioning

confidence: 99%

Decision Making in Patients With Metastatic Spine. The Role of Minimally Invasive Treatment Modalities

et al. 2019

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Spine metastases affect more than 70% of terminal cancer patients that eventually suffer from severe pain and neurological symptoms. Nevertheless, in the overwhelming majority of the cases, a spinal metastasis represents just one location of a diffuse systemic disease. Therefore, the best practice for treatment of spinal metastases depends on many different aspects of an oncological disease, including the assessment of neurological status, pain, location, and dissemination of the disease as well as the ability to predict the risk of disease progression with neurological worsening, benefits and risks associated to treatment and, eventually, expected survival. To address this need for a framework and algorithm that takes all aspects of care into consideration, we reviewed available evidence on the multidisciplinary management of spinal metastases. According to the latest evidence, the use of stereotactic radiosurgery (SRS) or stereotactic body radiotherapy (SBRT) for spinal metastatic disease is rapidly increasing. Indeed, aggressive surgical resection may provide the best results in terms of local control, but carries a significant rate of post-surgical morbidity whose incidence and severity appears to be correlated to the extent of resection. The multidisciplinary management represents, according to current evidence, the best option for the treatment of spinal metastases. Noteworthy, according to the recent literature evidence, cases that once required radical surgical resection followed by low-dose conventional radiotherapy, can now be more effectively treated by minimally invasive spinal surgery (MISS) followed by spine SRS with decreased morbidity, improved local control, and more durable pain control. This combination allows also extending this standard of care to patients that would be too sick for an aggressive surgical treatment.

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“…Any tumor has the potential to seed the vertebral column, but spinal metastases are most common secondary to lung (24% of cases), breast (24%), liver (12%), prostate (11%), and kidney (11%) primary tumors (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Though the majority of these lesions are subclinical, as much as 10% of patients may present with symptoms of mechanical instability or epidural cord compression (10,23,24), including weakness, sensory disturbances, bowel or bladder dysfunction, and gait disturbance.…”

Section: Introductionmentioning

confidence: 99%

“…Because of these advances, some centers are now moving towards utilizing "separation surgery" as their standard of care (78,79). In this treatment method, patients are first surgically decompressed and then treated with high dose, single fraction (18)(19)(20)(21)(22)(23)(24) or hypofractionated (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) Gy in 3-6 fractions) focal radiation (78)(79)(80)(81). The aim of surgery in these cases is to create a resection cavity around the spinal cord at the lesion level, and then to address the remaining tumor using the stereotactic radiation.…”

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confidence: 99%

Minimally invasive versus conventional spine surgery for vertebral metastases: a systematic review of the evidence

et al. 2018

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One of the major determinants of surgical candidacy in patients with symptomatic spinal metastases is the ability of the patient to tolerate the procedure-associated morbidity. In other pathologies, minimally invasive (MIS) procedures have been suggested to have lower intra-operative morbidity while providing similar outcomes. We conducted a systematic review of the PubMed library searching for articles that directly compared the operative and post-operative outcomes of patients treated for symptomatic spinal metastases. Inclusion criteria were articles reporting two or more cases of patients >18 years old treated with MIS or open approaches for spinal metastases. Studies reporting results in spinal metastases patients that could not be disentangled from other pathologies were excluded. Our search returned 1,568 articles, of which 9 articles met the criteria for inclusion. All articles were level III evidence. Patients treated with MIS approaches tended to have lower intraoperative blood loss, shorter operative times, shorter inpatient stays, and fewer complications relative to patients undergoing surgeries with conventional approaches. Patients in the MIS and open groups had similar pain improvement, neurological improvement, and functional outcomes. Recent advances in MIS techniques may reduce surgical morbidity while providing similar symptomatic improvement in patients treated for spinal metastases. As a result, MIS techniques may expand the pool of patients with spinal metastases who are candidates for operative management.

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Neuroimaging of spine tumors

Cited by 23 publications

References 54 publications

Diagnosis of benign notochordal cell tumor of the spine: is a biopsy necessary?

Diagnosis of benign notochordal cell tumor of the spine: is a biopsy necessary?

Decision Making in Patients With Metastatic Spine. The Role of Minimally Invasive Treatment Modalities

Minimally invasive versus conventional spine surgery for vertebral metastases: a systematic review of the evidence

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