Anterolateral decompression for metastatic epidural spinal cord tumors. Results of a modified costotransversectomy approach.
Since 1981, 12 patients with epidural spinal cord compression from metastatic carcinoma have been treated surgically by a modified costotransversectomy approach for anterolateral decompression. Before surgery, all patients had received dexamethasone, and had deteriorated neurologically despite radiation therapy, chemotherapy, or steroid therapy. Postoperatively, nine patients (75%) improved neurologically and were ambulatory, two (17%) had no change in neurological status, and one patient was unchanged initially but deteriorated and died 8 weeks later. Anterolateral decompression by a modified costotransversectomy approach should be considered for management of ventrally located tumors or when posterior stabilization is considered a possible requirement following a proposed anterior decompression.
D000230:Adenocarcinoma / Q000150:complications / Q000556:secondary / Q000601:surgery*; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology; D002277:Carcinoma / Q000150:complications / Q000556:secondary / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary; D005260:Female; D006801:Humans; D007223:Infant; D007890:Leiomyosarcoma / Q000150:complications / Q000473:pathology / Q000556:secondary; D008297:Male; D008479:Mediastinal Neoplasms / Q000473:pathology; D008875:Middle Aged; D009669:Nose Neoplasms / Q000473:pathology; D011471:Prostatic Neoplasms / Q000473:pathology; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000556:secondary / Q000601:surgery*; D013274:Stomach Neoplasms / Q000473:pathology