Abstract
Purpose of the study
To review the primary bone tumours of the spine treated at our unit.
Description of methods
Retrospective review of folders and x-rays of all the patients with primary bone tumours of the spine treated at our unit between 2005 and 2012. All haematological tumours were excluded.
Summary of results
We treated 15 cases during this period. The median age at presentation was 36 years (8–65). There was a significant delay from onset of symptoms to diagnosis in most cases (median 7 months). Histological diagnoses included:
| -Benign tumours | ||
| Active | Hemangioma | 3 |
| Osteoid osteoma | 1 | |
| Eosinophilic granuloma | 1 | |
| Aggressive | Osteoblastoma | 1 |
| Giant cell tumours | 2 | |
| Aneurysmal bone cysts | 4 | |
| -Malignant tumours | ||
| Osteosarcomas | 2 | |
| Leiomyosarcoma of bone | 1 |
A variety of definitive surgical methods were utilised. Seven patients had a debulking or intralesional resection of the tumour. Eight patients had an attempted marginal excision. This was achieved through anterior surgery only in 1 case, posterior only surgery in 6 cases and combination anterior and posterior surgery in 8 cases. The anterior and posterior surgery was performed in a single sitting in 5 cases and in a staged fashion in 3 cases. Adjuvant radiotherapy and chemotherapy were used where indicated.
Three cases presented with significant neurological impairment. Of these 2 made a significant recovery. There were no cases of neurological deterioration following surgery. All 3 patients with malignant tumours died in the follow up period. We had 1 case of hardware failure due to chronic sepsis.
Conclusion
Primary bone tumours of the spine are associated with a significant delay in diagnosis. Surgical treatment options and adjuvant therapy should be tailor made for each case depending on the diagnosis. Acceptable results with minimal complications can be achieved with this approach.
