[Orthopedic local treatment of metastatic bone tumor]

Since 1971, we have treated 76 patients with metastatic bone tumor. Forty-eight of 76 cases were treated surgically. In 34 cases, removal of metastatic foci of the spine was attempted from the anterior and/or posterior approach. In the remaining 14 cases, resection of the tumor with or without prosthetic replacement, osteosynthesis, or amputation was performed according to the site of bone metastasis. In cases of spinal metastasis, if foci were located anteriorly, resection and replacement of vertebral body by ceramic spacer and/or bone cement was effective for both relief of pain and reduction of paralysis. If foci were located posteriorly, however, the results of simple laminectomy were poor, and those of spinal instrumentation in addition to laminectomy were satisfactory. In the treatment of metastatic foci of pelvis, scapula and long bone, the results of orthopedic surgery were satisfactory, because relief of pain and maintenance of function were achieved in almost all cases. From the standpoint of prolongation of life, 15 out of 76 cases (20%) were alive with or without disease; 13 of them were treated not only surgically but also by radiation and/or chemotherapy.