Primary bone tumours of the spine: a 42-year survey from the Leeds Regional Bone Tumour Registry

Kelley, Simon P.; Ashford, Robert U.; Rao, Abhay; Dickson, Robert A.

doi:10.1007/s00586-006-0188-7

Cited by 160 publications

(122 citation statements)

References 15 publications

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“…54,55 Five-year survival rates as high as 90% have been reported for patients with low-grade tumors, while the corresponding rates for patients with high-grade tumors are 40%-50%. 46,[55][56][57][58][59] We have used image guidance in treating patients with chondrosarcoma to improve our surgical margins while limiting our complications by avoiding excessive bone resection and preserving neurovascular structures. Our intraoperative goal is to obtain at least a 2-cm margin from the tumor seen on intraoperative CT and correlated with MRI.…”

Section: Surgical Pearlsmentioning

confidence: 99%

Image-guided resection of aggressive sacral tumors

Drazin¹,

Bhamb

Al-Khouja³

et al. 2017

FOC

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OBJECTIVE The aim of this study was to identify and discuss operative nuances utilizing image guidance in the surgical management of aggressive sacral tumors. METHODS The authors report on their single-institution, multi-surgeon, retrospective case series involving patients with pathology-proven aggressive sacral tumors treated between 2009 and 2016. They also reviewed the literature to identify articles related to aggressive sacral tumors, their diagnosis, and their surgical treatment and discuss the results together with their own experience. Information, including background, imaging, treatment, and surgical pearls, is organized by tumor type. RESULTS Review of the institutional records identified 6 patients with sacral tumors who underwent surgery between 2009 and 2016. All 6 patients were treated with image-guided surgery using cone-beam CT technology (O-arm). The surgical technique used is described in detail, and 2 illustrative cases are presented. From the literature, the authors compiled information about chordomas, chondrosarcomas, giant cell tumors, and osteosarcomas and organized it by tumor type, providing a detailed discussion of background, imaging, and treatment as well as surgical pearls for each tumor type. CONCLUSIONS Aggressive sacral tumors can be an extremely difficult challenge for both the patient and the treating physician. The selected surgical intervention varies depending on the type of tumor, size, and location. Surgery can have profound risks including neural compression, lumbopelvic instability, and suboptimal oncological resection. Focusing on the operative nuances for each type can help prevent many of these complications. Anecdotal evidence is provided that utilization of image-guided surgery to aid in tumor resection at our institution has helped reduce blood loss and the local recurrence rate while preserving function in both malignant and aggressive benign tumors affecting the sacrum.

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Section: Surgical Pearlsmentioning

confidence: 99%

Image-guided resection of aggressive sacral tumors

Drazin¹,

Bhamb

Al-Khouja³

et al. 2017

FOC

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“…6,20 Although several animal models of primary malignant bone tumors have been described, 3,5,8,9,19,23 there are no animal models of any primary malignant bone tumor in the spine; therefore, none of them addresses the sequence of events …”

mentioning

confidence: 99%

Orthotopic murine model of a primary malignant bone tumor in the spine: functional, bioluminescence, and histological correlations

Fahim

Tatsui²,

Suki³

et al. 2014

SPI

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Object There is currently no reproducible animal model of human primary malignant bone tumors in the spine to permit laboratory investigation of the human disease. Therefore, the authors sought to adapt their previously developed orthotopic model of spinal metastasis to a model for primary malignant bone tumors of the spine. Methods A transperitoneal surgical approach was used to implant osteosarcoma (Krib-1) into the L-3 vertebral body of nude mice via a drill hole. Motor function was evaluated daily using the previously validated qualitative key milestones of tail dragging, dorsal stepping, hindlimb sweeping, and paralysis. A subset of these animals was euthanized upon reaching the various milestones, and the spines were removed, sectioned, and stained. The degree of spinal cord compression was correlated with the occurrence of milestones and assessed by a ratio between the neural elements divided by the area of the spinal canal. Another subset of animals received stably transfected Krib-1 cells with the luciferase gene, and bioluminescence was measured at 10, 20, and 30 days postimplantation. Results Osteosarcoma xenografts grew in all animals according to a reliable and reproducible time course; the mean time for development of behavioral milestones was noted in relation to the day of implantation (Day 1). Tail dragging (Milestone 1) occurred on Day 19.06 (95% CI 16.11–22.01), dorsal stepping (Milestone 2) occurred on Day 28.78 (95% CI 26.79–30.77), hindlimb sweeping (Milestone 3) occurred on Day 35.61 (95% CI 32.9–38.32), and paralysis of the hindlimb (Milestone 4) occurred on Day 41.78 (95% CI 39.31–44.25). These clinically observed milestones correlated with increasing compression of the spinal cord on histological sections. The authors observed a progressive increase in the local bioluminescence (in photons/cm2/sec) of the implanted level over time with a mean of 2.17 (range 0.0–8.61) at Day 10, mean 4.68 (range 1.17–8.52) at Day 20, and mean 5.54 (range 1.22–9.99) at Day 30. Conclusions The authors have developed the first orthotopic murine model of a primary malignant bone tumor in the spine, in which neurological decline reproducibly correlates with tumor progression as evidenced by pathological confirmation and noninvasive bioluminescence measurements. Although developed for osteosarcoma, this model can be expanded to study other types of primary malignant bone tumors in the spine. This model will potentially allow animal testing of targeted therapies against specific primary malignant tumor types.

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“…Benign tumours comprise 23% of them [7]. Patients can be asymptomatic although most of them may present with local pain.…”

Section: Discussionmentioning

confidence: 99%

Chondromyxoid fibroma of the lumbar spine: case report and literature review

Gutiérrez-González¹,

Reina²,

Saab³

et al. 2011

Eur Spine J

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Purpose Chondromyxoid fibroma (CMF) is a benign tumour of the bone that typically occurs in long bone metaphysis. Spinal involvement is uncommon, but more frequent in the cervical and thoracic segments. Lumbar involvement is extremely rare. We report the ninth case of lumbar CMF and the first one involving the articular process of the vertebra. A review of the literature is also intended making special emphasis on the differential diagnosis with other benign spinal tumours of the bone. Methods A 21-year-old Caucasian male suffering from low back pain that increased with sports and interrupted sleep was diagnosed with a tumoural lesion in the right inferior articular process of L5. Results Complete surgical excision of the tumour was accomplished. Histological diagnosis confirmed a CMF. The patient remains asymptomatic at 1-year follow-up. Conclusion Despite the low incidence of CMF in the lumbar spine, differential diagnosis must include this subtype of lesion among other benign tumours of the bone and cartilage. Histological diagnosis is essential in order to provide the patient with an accurate management of the pathology. Recurrence rate is to be considered even in the case of complete surgical excision. Radiotherapy administration is controversial due to suspicion of malignant transformation of the tumour.

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Primary bone tumours of the spine: a 42-year survey from the Leeds Regional Bone Tumour Registry

Cited by 160 publications

References 15 publications

Image-guided resection of aggressive sacral tumors

Image-guided resection of aggressive sacral tumors

Orthotopic murine model of a primary malignant bone tumor in the spine: functional, bioluminescence, and histological correlations

Chondromyxoid fibroma of the lumbar spine: case report and literature review

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