title: Application of internal stabilisation in the surgical treatment of spinal metastases.
abstract: OBJECTIVE
  Neoplastic disease damages the spine more often than trauma. Metastatic tumour causes vertebral column instability and neurological deficit. Surgical intervention indications depend on the patient's general and neurological status. The aim of neuro-orthopaedic treatment is to achieve pain relief and neurological improvement. Spine stability is secured by various implant systems. The aim of the paper is to present indications, operative techniques and stabilisation methods in patients with metastatic spine disease.
  
  
  METHODS
  There were 73 patients included in this study: 50 males and 23 females, aged 17-74 years. The dominant tumour location was the thoracic spine (41 cases), followed by the lumbar spine (19). Symptoms of spinal cord lesion were observed in 71 patients. Qualification for surgery and approach planning were based on different scales (ASA, DeWald, Frankel, Karnofsky, Denis, Tomita). Internal stabilisation implantation followed tumour resection.
  
  
  RESULTS
  Anterior approach was used in 15 cases, posterolateral in 39, posterior in 13, and combined in 6 cases. Histological findings generally allowed the primary tumour location to be disclosed, which in most cases involved the kidney, prostate, lung and the haematopoietic system. Neurological improvement was observed in 82% of cases. Perioperative death occurred in 3% of all patients.
  
  
  CONCLUSIONS
  Employed operative techniques are adequate for tumour removal, neural and vascular structures decompression and for implant placement.
authors.affiliation: Katedra i Klinika Neurochirurgii i Neurotraumatologii, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu, ul. Przybyszewskiego 49, 60-355 Poznań. klinikanch@op.pl
authors.forename: Roman
authors.initials: R
authors.lastname: Jankowski
authors.forename: Stanisław
authors.initials: S
authors.lastname: Nowak
authors.forename: Ryszard
authors.initials: R
authors.lastname: Zukiel
authors.forename: Tomasz
authors.initials: T
authors.lastname: Blok
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Paprzycki
authors.forename: Janusz
authors.initials: J
authors.lastname: Szymaś
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011044:Poland; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D013125:Spinal Neoplasms / Q000556:secondary* / Q000601:surgery*; D013131:Spine / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D013904:Thoracic Vertebrae / Q000601:surgery; D016896:Treatment Outcome