[Treatment strategy of malignant bone tumors of the spine]

In patients with big, tumorous changes in the vertebral bodies, conservative measures like radiotherapy, medical therapy, and external support measures are often no longer applicable. As a result of the instability of the spinal column, most of the patients are bedridden and in great pain. Signs of root compression occur frequently, as do incipient or incomplete transverse lesions. On the one hand, these signs result from tumor growth and on the other from collapse of the vertebral bodies with kyphosis and fragment dislocation in the spinal canal. In these patients the procedure of choice is "ventral" tumor removal, decompression of the spinal cord and roots, followed by stabilization. By the "dorsal" operative method, it is not possible to overcome the major cause of the instability and pain. On the basis of the results obtained in 100 "ventral" resections of the vertebral bodies, the treatment strategy is presented, ranging from the preliminary examination to the postoperative period.