Total en bloc Spondylectomy for Solitary Metastatic Spinal Tumor.
10.4184/jkss.2003.10.4.303
- Author:
Ki Tack KIM
1
;
Chung Soo HAN
;
Kyung Soo SUK
;
Young Ho LEE
;
Sang Hun LEE
Author Information
1. Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea. ktkim@khmc.or.kr
- Publication Type:Original Article
- Keywords:
Solitary metastasis;
Total en bloc spondylectomy
- MeSH:
Back Pain;
Classification;
Follow-Up Studies;
Humans;
Neoplasm Metastasis;
Neurologic Manifestations;
Recurrence;
Retrospective Studies;
Spine
- From:Journal of Korean Society of Spine Surgery
2003;10(4):303-310
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: To analyze the clinical and radiological outcomes retrospectively. PURPOSE: To evaluate the efficacy of a total en bloc spondylectomy in solitary metastatic spinal tumors. SUMMERY OF LITERATURE REVIEW: In a conventional operation of a spinal metastatic tumor it is difficult to perform a wide excision, and several reports have suggested a total en bloc spondylectomy for wide or marginal resections. MATERIALS AND METHODS: Ten patients, with solitary spinal metastasis, were underwent a total en bloc spondylectomy, with a mean follow-up of 15 months. The locations of the tumors were the thoracic spine and lumbar spine in 4 and 6 cases, respectively. The clinical and radiological outcomes were assessed using the McAfee pain scale, Frankel neurologic grading, radiological extent of the lesion and local recurrence. Metastatic spinal tumors were classified by the system of Tomita. A pathological study of the resected vertebra was performed to evaluate the surgical margin. RESULTS: The preoperative back pain was grades IV, III, II and 0 in 4, 3, 2 and 1 case, respectively. The postoperative back pain was grades III, I and 0 in 3, 1 and 6 cases by the McAfee pain scale, respectively. The neurologic deficit was improved completely in all cases. There were 3 and 7 cases of types 4 and 5 by the Tomita's classification, respectively. The pathological results were wide margin and marginal margin in 4 and 6 cases, respectively. There were no local recurrences at the time of the last follow-up. CONCLUSION: All patients maintained good clinical and radiological results. A total en bloc spondylectomy was a useful treatment option for solitary metastatic tumors.
