Transthoracic vetebrectomy for metastatic spinal tumors

[Objective]To evaluate the clinical results for patients with metastatic spinal tumors treated by means of anterior vertebral body resection,reconstruction,and stabilization.[Method]Twenty-one patients with metastatic spinal tumors were treated by means of anterior vertebral body resection,decompression,reconstruction with an adriamycin-bone cement packed Ti mesh cage or rib strut graft,and anterior fixation with locking plate and screw construction, all cases were analyzed retrospectively.There were 13 males and 8 females with the average age of 48.5 years old(ranged,32~68 years).The predominant primary tumors included lung cancer in 6 patients,renal cancer in 5,breast cancer in 5,and others in 5.The most common presenting symptoms were back pain in 20 patients,incompletely paralysis in 8 patients,complete paralysis in one patients.[Result]After surgery,all patients were reviewed.The mean follow-up period was 24 months(ranged,6~56 months).Pain decreased in 15 of all 20 patients.Ten patients who had low limbs weakness but could ambulate preoperatively regained normal strength.In the 9 patients without ambulatory ability,6 could walk after surgery and 3 were still unable to walk but showed improved motor function.Tumor reoccurred in 5 cases.[Conclusion]It suggests that transthoracic vertebrectomy and spinal stabilization can improve the quality of daily life considerably in cancer patients with spinal metastasis,it can significantly relieve pain,maintain or improve the neurological status.