Metastatic lesions of the cervical spine. A retrospective analysis of 20 cases

Twenty patients were surgically treated for metastatic lesions of the cervical spine. The primary cancer was known in 14 patients, breast cancer being the most prevalent. In six patients, the cervical metastasis was revelatory of cancer. Fourteen patients showed neurologic deficit. For the upper cervical spine, a posterior approach was employed. From C3 to C7, an anterior surgical approach was preferred. Since 1986, the authors have performed, after a corpectomy of one or more vertebrae, an acrylic corpoplasty reinforced with an anterior plate. Two cases of neurologic deterioration and one instability in lesions involving the lower cervical spine were encountered. The survival period for 17 patients was, on average, 11 months (ranging from 8 days to 46 months). Nineteen patients had pain relief. Of 14 patients with neurologic deficit, 9 experienced partial or total improvement. Three patients showed no neural recovery, whereas surgery worsened the conditions of two patients. For lower cervical lesions, the anterior approach is recommended even for C3 (retropharyngeal approach) or for cervicothoracic lesions.