[Surgical treatment of spinal metastases by stabilization using posterior plates screwed into the vertebral pedicles]

Ninety spinal metastases were treated by plating using a posterior approach. Fifty were thoracic or thoraco-lumbar, 11 in the upper cervical spine, 14 in the lower cervical spine and fifteen in the lumbar spine. Surgical fixation was followed by radiotherapy, chemotherapy or hormone therapy, when indicated. In the upper cervical region a special plate was screwed into the occiput. In the lower cervical spine fixation was accompanied by anterior vertebrectomy at the same procedure. In the entire series good stability was obtained in nine out of ten cases. Mortality during the first post-operative months was about 10 to 15 p. 100 dependent on the level. Two thirds of the patients gained some benefit from the operation. Cases with paraplegia and loss of independence had less favourable results than others. The ideal indications are threatened collapse of vertebrae, recent neurological impairment of severe pain resistant to conservative treatment.