[Comment on some spinal surgery].
Bone tumor metastases is relatively common. Approximately 5%-20% of spinal metastatic tumors will finally invade the spinal cord and exacerbate symptoms. The adoption of combined approach in recent years has significantly increased the survival rate. After excision of the tumors, internal fixation instrumentations are needed to stabilize the vertebrae. These procedures must be performed under the condition that the patients can tolerate the operation. Fused vertebra with instrumentation may cause degenerative diseases at the adjacent segments, which has been a problem of concern recently. Results of biomechanical tests indicated that these degenerative changes are related to the increased motion range of the neighboring segments. An old view is "the more rigid the instrumentation is, the better the results are", which has been disproved by clinical evidences. Improper use of internal spine fixation instrument should be avoided. Artificial intervertebral disc replacement can produce favorable short-time effects, however, its long-term effects and complications still requires further observations.
Lu
Shi-bi
SB
Institute of Orthopaedics, PLA General Hospital, Beijing 100853, China.
D006801:Humans; D016268:Internal Fixators; D007403:Intervertebral Disc / Q000601:surgery; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods; D013125:Spinal Neoplasms / Q000556:secondary* / Q000601:surgery; D013131:Spine / Q000601:surgery*