2005
DOI: 10.1007/s00586-004-0870-6
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Survival, complications and outcome in 282 patients operated for neurological deficit due to thoracic or lumbar spinal metastases

Abstract: We present survival, neurological function, and complications in a consecutive series of 282 patients operated for spinal metastases from January 1990 to December 2001. Our main surgical indication throughout this time period was neurological deficit rather than pain. Metastases from cancer of the prostate accounted for 40%, breast 15%, kidney 8%, and lung 7%. In 78% the level of decompression was thoracic and lumbar in 22%. Thirteen percent had a single metastases only, 64% had multiple skeletal metastases, a… Show more

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Cited by 166 publications
(138 citation statements)
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“…With the development of better treatment options for the primary cancer, survival periods in metastatic disease will increase and will most likely lead to a rise in the incidence of metastatic spine disease. There is consensus on the fact that surgery can be beneficial to patients presenting with SEM [1][2][3]; however, the optimal type of surgery to be used on an individual patient remains unclear. The goals of surgical intervention are to relieve pain and neurologic deficit by decompression of the spinal cord or cauda equina and stabilization of the spine.…”
Section: Introductionmentioning
confidence: 99%
“…With the development of better treatment options for the primary cancer, survival periods in metastatic disease will increase and will most likely lead to a rise in the incidence of metastatic spine disease. There is consensus on the fact that surgery can be beneficial to patients presenting with SEM [1][2][3]; however, the optimal type of surgery to be used on an individual patient remains unclear. The goals of surgical intervention are to relieve pain and neurologic deficit by decompression of the spinal cord or cauda equina and stabilization of the spine.…”
Section: Introductionmentioning
confidence: 99%
“…These symptoms should also be detected in patients with known prostate or breast cancer as hint of spinal metastases for a proper treatment to minimize the consequences of paraplegia. During this acute treatment a tumor staging is done by intraoperative biopsy and histology, tumor marker detecting and staging-CT [15,24]. As part of an interdisciplinary case conference the treatment regimen of the tumor should be specified ahead of the paraplegia treatment.…”
Section: Resultsmentioning
confidence: 99%
“…The reduction of a deformity and stabilization of the thoracic and lumbar spine is usually done by a dorsal fixation with a locking screw/rod system. If necessary, a mono-or multisegmental vertebral body resection is done with vertebral body replacement using bone graft or cage and augmentation with bone cement [24,25]. Postoperative application of the intensity-modulated radiotherapy, radionuclide therapy, androgen suppression or application of bisphosphonates should be decided in the interdisciplinary tumor conference [26,27].…”
Section: Discussionmentioning
confidence: 99%
“…It is also possible to achieve indirect decompression of the cord when performing posterior decompression with realignment of the cervical lordosis using posterior instrumentation (cervical region), and it provides a stronger fixation force using pedicle screw system than anterior fixation (any sites) [12][13][14][15][16][17][18][19]. The disadvantages of the posterior approach are that we cannot reconstruct the anterior column, although the biomechanicallyinsufficient part due to destructive change of the metastasis is mainly the anterior column (any sites), and also, we cannot achieve direct resection of the tumor (cervical region).…”
Section: Clinical Evaluationmentioning
confidence: 99%