Surgical staging and management of primary spinal tumors

Objective:To improve the management and to evaluate the outcome of primary spinal tumors.Method:Totally,there were 15 cases in this series,8 males and 7 females.Ages were from 9 to 59 years,the mean was 37 years.7 cases were benign tumors and the remaining 8 cases were malignant tumors.A new spinal tumor classification system(Weinstein-Boriani-Biagini,WBB)was applied in this study based on pre- CT and MRI images.Four kinds of surgical procedure were applied to en bloc excision of spinal tumors.They were (1)vertebrectomy in 5 cases,(2)corporectomy in 7 cases,(3)sagittal in 2 cases and (4) posterior arch in 1 case.Stabilization was achieved by bone graft and anterior or posterior instrumentation in all cases.Result:All patients had a pain relieve and motor function was improved in 12 patient.Average length of follow-up period was 4 5 years in benign tumor group, no recurrence was found in all patients.The mean follow-up time was 3 4 years in malignant group,5 patients were free of local recurrence and metastasis,one patient died of complication one year later.The remaining one had recurrence of L1 myoloma with deterioration of neurologic function.He was submitted to a second curettage with posterior stabilization.Conclusion:The WBB classification system prove helpful in developing surgical treatment protocol for these primary spinal tumors.Radical resection of primary spinal tumor and reconstruction with anterior or posterior stabilization were acceptable and efficacious in management of primary spinal tumors.