Reconstructive surgery in spinal tumours

Hussein, Ahmed A.; El-Karef, E.; Hafez, M.

doi:10.1053/ejso.2000.1079

Cited by 29 publications

(24 citation statements)

References 21 publications

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“…12 More recently, the concept of surgical stabilisation to provide pain relief and to treat progressive deformity has been introduced and the clinical results have been good. 13,14 Ability to walk is the single most important factor in the decision making process for surgical intervention in patients with cord compression. Findlay 15 and Bach et al 16 have reported that 70% of ambulant, 30% of paraperitic and 5% of paraplegic patients maintained ambulant status after surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of prognostic scores in decision making and predicting outcomes in metastatic spine disease

Majeed

Kumar

Bommireddy

et al. 2012

annals

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INTRODUCTION Management of metastatic spinal disease has changed significantly over the last few years. Different prognostic scores are used in clinical practice for predicting survival. The aim of this study was to assess the accuracy of prognostic scores and the role of delayed presentation in predicting the outcome in patients with metastatic spine disease. METHODS Retrospectively, four years of data were collected (2007)(2008)(2009)(2010). Medical records review included type of tumour, duration of symptoms, expected survival and functional status. The Karnofsky performance score was used for functional assessment. Modified Tokuhashi and Tomita scores were used for survival prediction. RESULTS A total of 55 patients who underwent surgical stabilisation were reviewed. The mean age was 63 years (range: 32-87 years). The main primary sources of tumours included myeloma, breast cancer, lymphoma, lung cancer, renal cell cancer and prostate cancer. Of the cases studied, 29 patients had posterior instrumented stabilisation alone, 10 patients had an anterior procedure alone and 16 patients (with an expected survival of more than one year) had both anterior and posterior procedures performed. Twenty-three patients presented with spinal cord compression. The mean follow-up duration was 9 months (range: 1-39 months). Patients who were treated within one week of referral survived longer than anticipated. Patients were divided into three groups based on their expected survival. Actual survival was better in all three groups after surgery. Discrepancies in scores were prominent in patients with myeloma, breast and prostate cancers. Functional outcome was better in patients under 65 years of age. CONCLUSIONS The prognostic scoring systems are not uniformly effective in all types of primary tumours. However, they are useful in decision making for surgical intervention, taking other factors into account, in particular the age of the patient, the type and stage of the primary tumour and general health.

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Section: Discussionmentioning

confidence: 99%

Accuracy of prognostic scores in decision making and predicting outcomes in metastatic spine disease

Majeed

Kumar

Bommireddy

et al. 2012

annals

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“…The primary function of these devices is to provide structural support to the anterior spinal column, which is known to transmit 80% of the axial load applied to the spine. 12 Pathologic processes such as trauma, 13 malignancy, 14 infection, 2 and congenital/developmental abnormalities 15 can involve the vertebral bodies, rendering them incapable of providing anterior column support and stability. Following resection, an ideal anterior spinal column reconstruction provides a mechanically stable construct between vertebral endplates that can maintain spinal alignment while facilitating the development of a biologically stable fusion mass.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Titanium Mesh Cylindrical Cages in Anterior Column Reconstruction After Thoracic and Lumbar Vertebral Body Resection

Dvorak¹,

Kwon²,

Fisher³

et al. 2003

Spine

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“…4,5,11 Table 2 lists the studies that describe patients with metastatic spinal cord compression, include more than 10 patients and provide sufficient information to allow comparison concerning the neurologic outcomes. 1,4,[11][12][13][14][15][16][17][18][19][20][21][22] As a description of the neurologic status before and after surgery, the Frankel score or a categorization by A categorization by function alone is also problematic, for example, because the inability to walk may be due to pain Posterior decompression and stabilization for spinal metastasis R Abel et al Question marks are used if the information could not be extracted from the paper.…”

Section: Discussionmentioning

confidence: 99%

Posterior decompression and stabilization for metastatic compression of the thoracic spinal cord: is this procedure still state of the art?

et al. 2008

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Study Design: Retrospective study utilizing the standard patient data documentation of a spinal cord injury (SCI) unit. Objective: To examine the efficacy and outcome of posterior decompression and stabilization for metastatic cord compression. Setting: Orthopedic university hospital with large SCI unit. Methods: The 34 consecutive patients who had presented with symptoms of spinal cord compression due to metastatic disease and progressive neurologic deficit were treated using a uniform surgical approach (posterior decompression and stabilization). After surgery, all treatment options available in a full-featured SCI unit were applied as necessary and suitable. Outcome was rated concerning neurologic function (American Spinal Injury Association, ASIA), functional status (Functional Independence Measure) and pain. The results were compared to the published results, focusing on publications describing results of anterior surgical approaches to the spine. Results: Evaluation of the results of the ASIA exams showed that progression of the neurologic deficit could be stopped in the majority of casesFhowever recovery of neurologic function was rare. The functional status could be improved markedly and good pain reduction was achieved. Conclusion: Immediate surgery can be recommended if the general condition of the patient warrants surgical intervention. Using accepted standards of documentation for SCI, a clear perspective of the results that can be expected is provided. Comparing the results of this study with the current literature there is no evidence that anterior approaches are superior.

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Reconstructive surgery in spinal tumours

Cited by 29 publications

References 21 publications

Accuracy of prognostic scores in decision making and predicting outcomes in metastatic spine disease

Accuracy of prognostic scores in decision making and predicting outcomes in metastatic spine disease

Effectiveness of Titanium Mesh Cylindrical Cages in Anterior Column Reconstruction After Thoracic and Lumbar Vertebral Body Resection

Posterior decompression and stabilization for metastatic compression of the thoracic spinal cord: is this procedure still state of the art?

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