[Surgery for spine tumors]

One hundred and nine patients with spine tumors were treated surgically at Chiba University Hospital and Chiba Cancer Center in 1977-1987. The primary spine tumors included 9 chordomas, 6 myelomas and 5 giant cell tumors. The metastatic spine tumors were from primary lesions of the lung, breast, kidney, thyroid, prostate, and unknown origin. Fifty-eight patients were treated surgically by the posterior procedure, 18 with the anterior procedure and 33 with the combined anterior and posterior procedure. According to Frankel's classification, changes in neurological status were evaluated. In the patients classified as degree A, B or C by Frankel's classification before surgery, 56% showed improvement of neurological deficit. With regard to pain, about 90% of patients treated with surgical decompression and stabilization had pain relief, although only 42% of 21 patients given laminectomy alone experienced pain relief. Among the patients treated with the anterior procedure or combined anterior and posterior procedure, 60% of non-ambulatory patients were ambulatory after surgery, but in patients treated with the posterior procedure, only 48% of non-ambulatory patients were ambulatory after surgery. In planning of the surgical treatment of spine tumors, immediate surgical decompression and stabilization should be indicated before complete paralysis develops due to rapid deterioration of neurological status, after which the anterior approach for anterior lesions and the combined approach for extensive lesions is indicated.