Surgical Resection and Reconstruction for Metastatic Spinal Tumors

Objective:Evaluation of the indications and results from surgical resection and reconstruction following the treatment of metastatic spinal tumors.Methods:A retrospective analysis was performed in 32(19 women and 13 men)patients with spinal metastasis underwent surgical treatment between April 2003 and April 2008.The thoracic vertebra was involved in 22 of them,lumbar vertebra in 7,and cervical region in 3.Among 27 of the 32 patients who had neurological dysfunctions,7 patients were completely paralyzed and 20 cases were incompletely paralyzed.All patients in this group had performed surgical treatment by anterior en-bloc or partial resection,decompression and reconstruction with interal fixation of the spine;or by laminectomy and reconstruction with internal fixation;or by anterior-posterior en-bloc resection and reconstruction with interal fixation.Relief of the pain,the function of spinal cord or nerve,and stability of vertebrae were monitored.Results:The follow-up ranged from 6 to 60 months.Pain relief was obtained in 30 of 32 patients(93.8%) and good neurological improvement was obtained in25 of the 27 patients.Among 3 completely paralyzed patients,2 patients experienced an improvement of neurological function from ASIA grade A or B to C or D after decompression.Postoperative radiological evaluation revealed that spinal segments height and normal spinal sequence were restored.The over-all one-year survival rate was 69%(22 cases).Conclusion:Surgical resection and reconstruction for spinal metastasis which lead to vertebra collapsed and unstable is possible to alleviate paralysis and pain from collapse and instability of spine and re-establish the stabilization of spine and improve the quality of life.