[Surgical treatment of spinal metastases].
Spinal metastasis often lead to two main complications: back pain and para or tetraplegia. Performed alone radiotherapy may be too slowly efficient to allow a neurological recovery. Laminectomy may improve the neurological signs but does not induce any change on root pain and it increases instability. A surgical procedure by a posterior approach including laminectomy and fixation by plates and transpedicular screws fits these two goals: decompression and stabilisation. The first 189 cases are reported: the first month lethality is about 15%. 81% of fixations remained unchanged. 21 out of the 62 patients with loss of autonomy recovered an ability to walk. Besides this palliative surgery, a total spondylectomy has been done 13 times in order to perform a curative surgery for unique metastasis of cancers with long life expectancy. An early walking is often possible and after healing of the wound, a complementary treatment with radio or chemo therapy may be started without any risk of pain or neurological compression.
Lapresle
P
P
Service de Chirurgie orthopédique, Hôpital de la Pitié, Paris.
Roy-Camille
R
R
Lazennec
J Y
JY
Mariambourg
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000209:etiology; D001860:Bone Plates; D005260:Female; D006801:Humans; D007796:Laminectomy; D008297:Male; D008875:Middle Aged; D009192:Myelography; D009382:Neoplasms, Unknown Primary; D009437:Neuralgia / Q000209:etiology; D010264:Paraplegia / Q000209:etiology; D011379:Prognosis; D013117:Spinal Cord Compression / Q000209:etiology; D013123:Spinal Fusion / Q000379:methods*; D013125:Spinal Neoplasms / Q000150:complications / Q000556:secondary* / Q000601:surgery
Traitement chirurgical des métastases vertébrales.