Surgical outcome and strategy for cervical metastasis
10.3760/cma.j.issn.0253-2352.2013.08.003
- VernacularTitle:颈椎转移瘤外科治疗效果及不同术式选择策略
- Author:
Feifei ZHOU
;
Liang JIANG
;
Xiaoguang LIU
;
Zhongjun LIU
;
Gengting DANG
- Publication Type:Journal Article
- Keywords:
Cervical vertebrae;
Neoplasm metastasis;
Surgical procedures,operative
- From:
Chinese Journal of Orthopaedics
2013;33(8):797-802
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate surgical strategy and outcome for cervical metastasis in different anatomical segments.Methods Data of 31 patients,who had undergone surgical treatment for cervical metastasis from 2001 to 2009,were retrospectively analyzed.Two anatomical regions were defined:upper cervical spine (C1 and C2)and subaxial cervical spine plus cervicothoracic junction (C3-T1).VAS score,Frankel grade,Tomita score and Karnofsky performance scale were used to evaluate pain,neurological status,expected survival time and general health.The improvement of symptoms,survival time and characteristics of surgical strategies for different anatomical regions were analyzed.Results Twenty-four patients were followed up successfully.An effective recovery in neck pain and quality of life was found after operation.The median survival time was 45.0 months.In upper cervical spine group,the surgical strategies included posterior occipitocervical fixation combined with 125I seed brachytherapy and other surgical methods,and the median survival time 48.0 months) of patients who underwent 125I seed brachytherapy was longer than that 22.0 of patients treated with other surgical methods.In C3-T1 metastasis group,patients who underwent combined anterior-posterior approach total spondylectomy had a longer survival time than those treated with anterior corpectomy.Conclusion Surgical treatment can effectively relief neck pain,maintain or improve neurological function and improve quality of life.Doctors should choose different surgical strategies according to anatomical region of cervical metastasis.For upper cervical spine,the main purpose of surgery is to stabilize the cervical spine; the posterior occipitocervical fixation is usually chosen,and the 125I seed brachytherapy is useful in local control of metastasis.For subaxial cervical spine and cervicothoracic junction,the anterior corpectomy is usually chosen,and a combined anterior-posterior approach total spondylectomy can be used for patients with corresponding conditions.
