Metastatic spine disease in renal cell carcinoma--indication and results of surgery

Metastatic spine disease is frequent in renal cell carcinoma and 50% of osseous metastases are already found at the time of primary diagnosis. Therefore patient mobility and quality of life are threatened early in the course of disease. Surgery is able to relieve pain and to regain or to preserve mobility. Indication and technique of surgery (anterior decompression, vertebral replacement and transpedicular fixation) are explained and treatment results of eleven cases are reported. All patients with paraparesis or cord compression preoperatively were mobile when leaving our hospital after surgery. There were no severe complications, especially no neurological deteriorations or deaths. Postoperative survival time was ten months approximately in cases with multiple osseous lesions and it was several years in cases with solitary metastases. Mobility was preserved for most of the survival time. In conclusion, restabilisation of the spine proved to be a worthwhile treatment option in well-selected cases suffering from malignant spinal involvement.