title: [Tumours and metastases of the spine : cavity/coblation surgery and vertebroplasty/kyphoplasty].
abstract: BACKGROUND
  Radical surgery for metastases in the spine is in many cases not possible, includingthe higher risk of surgery in older patients with co-morbidities. The aims of treatment are: minimally invasive and maximally effective tumour removal, fracture position, stabilization, pain reduction, and improved quality of life. The specific features and problems of diagnosis and treatment using the cavity/coblation method, , the surgical technique, and the results of the treatment of 250 patients with spinal tumours/metastases are presented.
  
  
  METHODS
  Tumour resection is carried out by plasma field, via percutaneous trans-/extrapedicular access, followed by kyphoplasty. Clinical and radiological follow-up was carried out postoperatively, including data on pain reduction and improvement of quality of life.
  
  
  RESULTS
  Within 6 years (March 2008t February 2014) a total of 250 patients, or 812 spines were treated. In 59 cases dorsal percutaneous instrumentation and straightening were carried out. Minimal blood loss and a very low complication rate were recorded. After surgery, significant pain reduction, satisfaction, early mobilization, and improvement in quality of life were demonstrated in all patients. Immediate radio- and chemotherapy could be carried out. In 38 cases cement escaped laterally into the intervertebral space, but this had no clinical relevance. 188 patients have since died because of tumour manifestations.
  
  
  CONCLUSIONS
  The cavity/coblation method has been demonstrated to be a safe, minimally invasive procedure, with good short- and long-term results and lower complication rates. A comprehensive diagnostic, including tumour staging, the correct indication, and prognosis estimation, is important.
authors.affiliation: Klinik für Orthopädie und Orthopädische Chirurgie, Ernst-Moritz-Arndt University Greifswald, Greifswald, Deutschland. dimdobrow@mail.ru.|Zentrum für Orthopädie und Wirbelsäulenchirurgie Fichtelgebirge, Marktredwitz, Deutschland. dimdobrow@mail.ru.
authors.forename: D
authors.initials: D
authors.lastname: Dabravolski
authors.affiliation: Klinik für Orthopädie und Orthopädische Chirurgie, Ernst-Moritz-Arndt University Greifswald, Greifswald, Deutschland.|Kliniken Maria Hilf GmbH, Mönchengladbach, Academic Teaching Hospital of the RWTH Aachen, Mönchengladbach, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Lahm
authors.affiliation: Klinik für Orthopädie und Orthopädische Chirurgie, Ernst-Moritz-Arndt University Greifswald, Greifswald, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Eßer
authors.affiliation: Klinik für Orthopädie und Orthopädische Chirurgie, Ernst-Moritz-Arndt University Greifswald, Greifswald, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Merk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000627:therapeutic use*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D058498:Kyphoplasty / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence; D012307:Risk Factors; D013125:Spinal Neoplasms / Q000453:epidemiology / Q000556:secondary* / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements
keywords: Minimally invasive surgical procedures; Multimodal therapy; Osteolysis; Spinal fractures; Treatment outcome