SP9: EN BLOC RESECTION OF METASTATIC AND EXTENSIVE SPINAL MALIGNANCY

Abstract

Traditional management of spinal metastases has been for the most part palliative. In this decade however there has been a gradual shift towards extirpative treatment of spinal secondary malignancy in certain circumstances. The techniques of en bloc vertebral resection have gained more widespread acceptance improving the chances of successful wide or marginal resection of both primary and secondary tumours of the spine. Those metastatic lesions which are solitary and associated with a long period of latency from treatment of the primary lesion have a greater likelihood of improved survival with en bloc resection. Although technically demanding, these same techniques coupled with advances in spinal implantation may allow complete excision of extended primary malignancy of the spine previously considered unresectable. This presentation examines the indications for en bloc resection of secondary and extended primary malignancy of the spine. A case for early referral of solitary metastatic spinal lesions is presented in the hope of adding extirpative surgical techniques to the traditional armamentarium of theoncologist.