Management of metastatic tumors to the spine using simple plate fixation.
Frequency of metastasis to the spine in the population of patients suffering from malignant disease is a significant clinical problem, as these patients present with intractable pain and neurologic impairment. The sequelae of metastatic tumors to the spinal column significantly decrease the quality of the patient's life. With the advent of modern chemotherapeutic regimens in metastatic disease, patients with metastatic tumors are living longer and more productive lives. The goal of surgical management of this problem is to increase the quality of the patient's life, and not longevity. The immediate technical goals are resection of the pathological segment, restoration of load bearing capacity for mobilization of the patient, and decompression of compromised neural structures, as well as maintenance of spinal stability to decrease pain and increase the patient's quality of life during the terminal stages. This is a series of 28 patients with metastatic tumors to the spine, with an average age of 61.5 years, ranging from 25-81 years of age. Within this population there were 11 different tumor types. The postoperative survivorship was an average of 6.4 months. Twenty patients in this series had an anterior procedure alone using a combination of Methylmethacrylate and inexpensive plate fixation. Six patients required an anterior/posterior procedure for circumferential spinal compression and instability. These techniques provide immediate spinal stability for rapid mobilization of the patient. Twenty-four patients in the series had significant pain relief, and 17 experienced neurologic improvement.(ABSTRACT TRUNCATED AT 250 WORDS)
Timlin
M
M
Royal College of Surgeons in Ireland, Dublin.
Thalgott
J
J
Ameriks
J
J
Jordan
F
F
Kabins
M
M
Gardner
V
V
Fritts
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D016025:Bone Transplantation; D004867:Equipment Design; D006801:Humans; D020366:Methylmethacrylate; D008768:Methylmethacrylates; D008875:Middle Aged; D009068:Movement; D010148:Intractable Pain / Q000517:prevention & control; D011788:Quality of Life; D013117:Spinal Cord Compression / Q000601:surgery; D013118:Spinal Cord Diseases / Q000517:prevention & control; D013125:Spinal Neoplasms / Q000556:secondary* / Q000601:surgery*; D013131:Spine / Q000601:surgery; D015996:Survival Rate; D013727:Terminal Care; D016474:Weight-Bearing
D008768:Methylmethacrylates; D020366:Methylmethacrylate