Primary tumors of the cervical spine: a retrospective review of 35 surgically managed cases.
BACKGROUND
Primary tumors of the cervical spine are rare, and many issues regarding their surgical management remain unanswered yet.


OBJECTIVE
To demonstrate results of surgery for primary tumors of the cervical spine and to elucidate which factors influence outcome.


METHODS
Retrospective study.


METHODS
Sixty-six surgeries were performed on 35 patients, ranging in age from 7 to 70 years.


METHODS
Preoperative and postoperative degree of pain and neurological status were quantified. Radiological investigations were used to detect recurrence and evaluate the stability and fusion.


METHODS
Data were collected on patient characteristics, therapy, and results. Follow-up ranged from 6 months to 15 years (mean 59.9 months).


RESULTS
Posterior (26), anterolateral (24), retropharyngeal (9), combined (4), lateral (2), and transmandibular approaches (1) were used. Chordomas (n=8) and 17 different types of tumors were encountered. One patient died 3 weeks postoperatively and 5 died of their disease at follow-up. Twenty patients had no evidence of disease, and 7 patients had recurrent tumors. According to the Weinstein-Boriani-Biagini classification, tumor extension into both anterior and posterior columns of a vertebra was correlated with a poor outcome. Incomplete resections resulted in tumor recurrence which warranted subsequent surgeries (up to 9), especially in chordoma cases.


CONCLUSIONS
Complete tumor resection is the oncologically best surgical strategy and should be attempted whenever possible. However, this may not be feasible in every case because of the complexity of the cervical spine. In these cases, acceptable mortality-morbidity rates and symptom-free years could be achieved by subtotal resections, even for malignant tumors.
Zileli
Mehmet
M
Department of Neurosurgery, Ege University Faculty of Medicine, Bornova, Izmir 35100, Turkey. mehmet.zileli@ege.edu.tr
Kilinçer
Cumhur
C
Ersahin
Yusuf
Y
Cagli
Sedat
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000473:pathology* / Q000601:surgery*; D002648:Child; D002817:Chordoma / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010146:Pain / Q000209:etiology; D020127:Recovery of Function; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome