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Transthoracic vertebrectomy for metastatic spinal tumors
Z L Gokaslan1, J E York, G L Walsh
1Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Journal of Neurosurgery
|October 7, 1998
Summary
Transthoracic vertebrectomy effectively treats thoracic spinal metastases, improving pain and ambulation in cancer patients. This procedure offers significant quality of life benefits with acceptable risks.
Area of Science:
- Oncology
- Neurosurgery
- Orthopedic Surgery
Background:
- Anterior spinal approaches are increasingly used for spinal tumors.
- Previous studies often combined diverse tumor types and spinal regions.
- A focused analysis of thoracic spinal metastases is needed.
Purpose of the Study:
- To evaluate outcomes of anterior vertebral body resection, reconstruction, and stabilization for thoracic spinal metastases.
- To provide a clear perspective on expected results for this specific patient group.
Main Methods:
- Retrospective review of 72 patients with metastatic spinal tumors treated with transthoracic vertebrectomy.
- Procedures included decompression, methylmethacrylate reconstruction, and anterior fixation.
- Analysis of pain, neurological function, ambulation, complications, and survival rates.
Main Results:
- Pain improved in 60/65 patients (statistically significant).
- Neurological function improved in 35/46 patients (statistically significant).
- 10/13 nonambulatory patients regained ambulation; 17/33 ambulatory patients regained normal strength. 30-day mortality was 3%, 1-year survival was 62%.
Conclusions:
- Transthoracic vertebrectomy and stabilization significantly improve quality of life for thoracic spinal metastasis patients.
- The procedure restores/preserves ambulation and controls intractable pain.
- Acceptable morbidity and mortality rates support this approach.