[Surgical treatment of metastatic lung cancer to thoracic supine]

This article reports the author's experience with the surgical treatment of metastatic lung cancer to the thoracic spine. A 65-year-old woman (case 1) had undergone a right upper lobectomy with a diagnosis of adenocarcinoma. Three years later, she complained of severe back pain, and visited our hospital. CT scan showed a metastatic spine disease (Th6 and 7) which caused the back pain. A 59-year-old woman (case 27 was admitted to our hospital complaining of an abrupt onset of paraplegia. Two years ago, she underwent left upper lobectomy with a diagnosis of adenocarcinoma. Urgent examination revealed a large metastatic lesion on Th5 and 6 which compressed the spinal cord. After excision of the tumor as extensively as possible, the both patients underwent surgical decompression of the spinal cord, bone grafting and posterior reconstruction of the spine with a metallic instrumentation. Severe back pain was relieved postoperatively. Improvement of neurological deficit was dramatic in case 2. The goal of surgical treatment of metastatic thoracic spine disease is to improve the quality of the remaining life, by relief of pain and preservation or restoration of neurologic function. The dismal consequences of prolonged bed rest, paraplegia, and a painful premature death can be avoided with thoughtful and timely surgical treatment.