SPINAL TUMORS: SURGICAL TREATMENT

Abstract

The aim of this paper is to study patients who have had surgery for spinal tumors. Indications for surgical treatment are pain(not resolving with analgesics), impending as well as manifested neurologic symptomatology or spinal instability, compression of neighboring structures and failure of radiotherapy or chemotherapy. In this study we present 50 patients, 30 women and 20 men, aged 15 to 75, suffering from benign(10 pts), malignant(15 pts)and metastatic(25 pts) spinal tumors. All were treated surgically by wide excision during a four-year period (1997–2002) using an anterior, posterior, posterolateral or combined approach to the spine. Most of the 30 pts who presented with neurologic compromise improved to a significant degree postoperatively with the exception of 5 whose condition did not change. One patient, whose preoperative neurologic status was Frankel D, deteriorated postoperatively and underwent a second operation to no avail. One patient died on day 12 p.op. CT-assisted biopsy was not successful in half the patients with metastatic cancer. 18 patients suffering from malignancy(primary or metastatic) underwent angiography and selective embolism of the feeding vessels. All patients were evaluated preoperatively by CT-scan, MRI, bone scan and in most cases myelography as well. Complications that were observed were wound infection(3 pts), intraoperative meningeal trauma and CSF leak(2 pts) and lymfatic duct trauma and lymph leak(1 pt).