Spinal stabilization for patients with metastatic lesions of the spine using a titanium spacer.
Anterior decompression in spinal metastases of the corporal type with impending (n = 5) or present (n = 36) neurological complications was performed in 41 patients. For reconstruction, a titanium cylinder was inserted after spondylectomy and augmented with an anterior plate. The titanium implant can easily be adjusted to the length needed without necessitating expensive additional equipment. Outside the patient the implant is filled with polymethylmetacrylate, facilitating plate transfixation for rotational locking. There was a 30-day mortality of 9.7%. Pain relief was apparent in 38 of 41 patients (92.7%), and motor improvement was manifest in 31 of 35 cases (88.6%). Six patients did not present with any neurological symptoms pre- or postoperatively. Neurological deterioration was registered in only 1 case (2.4%). Surgical efficacy was maintained until the death of the patients. Though tumor recurrence at a different spinal level led to consecutive surgery in 5 patients, no implant dislocation occurred during the observation period (maximum 44 months), characterizing the procedure as a mechanically reliable and safe technique.
Hertlein
H
H
Unfallchirurgie, Chirurgische Klinik und Poliklinik der Universität München, Klinikum Grosshadern, München, Federal Republic of Germany.
Mittlmeier
T
T
Piltz
S
S
Schürmann
M
M
Kauschke
T
T
Lob
G
G
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods; D013125:Spinal Neoplasms / Q000556:secondary* / Q000601:surgery*; D013131:Spine / Q000473:pathology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome