title: [Anterior and anterolateral approach in the treatment of thoracic and lumbar vertebral metastasis causing spinal cord compression].
abstract: OBJECTIVE
  To analyse the results of the anterior and anterolateral approaches in the treatment of thoracic and lumbar spine metastasis.
  
  
  METHODS
  Patients who underwent surgery between 2003 and 2012 in our institution using an anterior or an anterolateral approach for the treatment of thoracic or lumbar spine metastasis were retrospectively reviewed.
  
  
  RESULTS
  Twenty-two patients with median age of 49.5 years (26-73 years) and median follow-up of 9.5 months (0-96 months) were analysed. The most common primary malignancies were renal cell carcinomas and breast adenocarcinomas. Before the intervention, 12 (54.5%) patients were able to walk (Frankel D and E). Preoperative arteriography was performed in 14 (63.6%) patients, and 7 (31.8%) of them underwent tumour embolisation. Medical complications occurred in 5 (22.7%) patients during the immediate postoperative period, 2 (9.1%) of whom died. At the end of follow-up, 16 (72%) of the remaining 20 patients were able to walk (Frankel D and E). Ninety percent of the patients could reduce at least 50% of their analgesic drug requirements. During follow-up 16 patients died, with a median survival of 10 months (range 0-48 months).
  
  
  CONCLUSIONS
  Resection of thoracolumbar vertebral metastases by an anterior/anterolateral approach, despite its considerable risk of morbidity and mortality, offers the possibility of significant improvement in the quality of life of the patient; and it does so not only by preserving or restoring their ability to walk but also by ameliorating pain. Preoperative angiography, considering the embolisation of the lesion, is an important tool.
authors.affiliation: Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, España. Electronic address: ajvargaslopez@hotmail.com.
authors.forename: Antonio José
authors.initials: AJ
authors.lastname: Vargas López
authors.affiliation: Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernández Carballal
authors.affiliation: Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Teresa
authors.initials: T
authors.lastname: Panadero Useros
authors.affiliation: Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Cristina
authors.initials: C
authors.lastname: Aracil González
authors.affiliation: Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Garbizu Vidorreta
authors.affiliation: Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Rosario
authors.initials: R
authors.lastname: González Rodrigálvarez
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000209:etiology* / Q000601:surgery*; D013125:Spinal Neoplasms / Q000150:complications* / Q000556:secondary / Q000601:surgery*; D013904:Thoracic Vertebrae
keywords: Abordaje anterior; Anterior approach; Cirugía; Columna; Metastasis; Metástasis; Spine; Surgery; Tratamiento; Treatment