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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 287 - 287
1 Mar 2004
Mazurkiewicz T Godlewski P Mazurkiewicz M Modrzewski K
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Aims: The purpose is to assess the risk of spinal cord compression in patients with spine metastases using radiological data. Methods: We evaluate 103 patients with the thoraco-lumbar vertebral body metastases Ð 52 with neurological symptoms of spinal cord compression and 51 symptoms free. We measured the statistical relation between spinal cord compression, pathological fracture, angle deformity of the spine and metastasis location. We divide spine into 3 columns and named pediculum as the fourth. We used statistical multiple regression analysis. Results: The risk of spinal cord compression is depended on the location of the metastasis in vertebral body (p< 0,01). We found spinal cord compression symptoms in 25 out of 31 patients in group with pediculum involvement and in 27 out of 72 in group with other locations. It was highly statistically important (p< 0.001). In 45 out of 68 patients with vertebral fractures we found spinal cord compression symptoms (p< 0.01). We did not found statistical correlation between angle deformity and compression symptoms. Conclusions: Compression risk is higher if the metastases are localised in thoraco-lumbar part of spine and if the pediculum is involved. The pathological fracture increases the risk of the compression, too.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 287 - 287
1 Mar 2004
Mazurkiewicz T Mazurkiewicz M Modrzewski K
Full Access

Aims: The purpose of the study is to evaluate the risk of fractures in long bones with metastases based on intact cortical bone index (ICBI) and functional assessment. Methods: We evaluate radiograms of 36 (25 fractures) and 86 patients (56 fractures) with the upper and lower extremity metastases, respectively. We measured on radiograms intact cortical bone index (ICBI) using the schedule K-G/K-J x100%, where is K-shaft diameter, G-size of destruction, J-bone marrow diameter above or below the metastases. We asses the extremity function by the ability to elevate and abduct it straight. Results: We found that fracture occurs if the ICBI is lower than 46% and 40% in upper and lower extremity, respectively. 7 (5,7%) patients develop fracture despite higher ICBI. If the metastases are located in upper part of the femur and humerus and he/she can not elevate or abduct the extremity the fracture inevitably occurs. Conclusions: Counting the ICBI and simple functional assessment allows to predict fracture in 94,3% of patients with long bone metastases.