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Spinal metastases surgery

Giulia R Mosele, Gianfilippo Caggiari, Roberto M Scarpa, Carlo Doria
BACKGROUND: Renal cell carcinoma (RCC) is among the 10 most common cancers in both men and women. It comprises 2-3% of all malignancies. The most common site for metastasis from RCC is the lung (50% of patients), followed by the skeleton (20% to 50% of patients). METHODS: We retrospectively reviewed our consecutive series of 63 patients surgically treated for spinal metastases from RCC. The surgical treatment for spinal metastases varied in each patient. Factors influencing the choice of surgery included age, disease status, symptoms, morbidity of the patient, the location, the number of repetitive lesions and the existence of extra-osseous metastases...
October 21, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Scott L Zuckerman, Ilya Laufer, Arjun Sahgal, Yoshiya J Yamada, Meic H Schmidt, Dean Chou, John H Shin, Naresh Kumar, Daniel M Sciubba
STUDY DESIGN: Systematic review. OBJECTIVE: The aim of this study was to review the techniques, indications, and outcomes of minimally invasive surgery (MIS) and separation surgery with subsequent radiosurgery in the treatment of patients with metastatic spine disease. SUMMARY OF BACKGROUND DATA: The utilization of MIS techniques in patients with spine metastases is a growing area within spinal oncology. Separation surgery represents a novel paradigm where radiosurgery provides long-term control after tumor is surgically separated from the neural elements...
October 15, 2016: Spine
Taisei Sako, Yasuaki Iida, Yuichirou Yokoyama, Shintaro Tsuge, Keiji Hasegawa, Akihito Wada, Tetsuo Mikami, Hiroshi Takahashi
Solitary epidural space metastasis of a malignant tumor is rare. We encountered a 79-year-old male patient with solitary metastatic epidural tumor who developed paraplegia and dysuria. The patient had undergone total gastrectomy for gastric cancer followed by chemotherapy 8 months priorly. The whole body was examined for suspected metastatic spinal tumor, but no metastases of the spine or important organs were observed, and a solitary mass was present in the thoracic spinal epidural space. The mass was excised for diagnosis and treatment and was histopathologically diagnosed as metastasis from gastric cancer...
2016: Case Reports in Orthopedics
Jyoti Pralhad Dabholkar, Neeti Madan Kapre
Nodal metastases is the most important prognostic marker for oral cavity cancers. Nodal dissection at level IIb risks damage to the spinal accessory nerve. We aim to study positivity of level IIb lymph nodes in oral cancers. In this non-randomized prospective observational study, 65 patients of oral cavity cancers were evaluated. Appropriate surgery for primary tumour and neck dissection were undertaken. All patients underwent level II b dissection. Out of 67 neck dissections (27 elective and 40 therapeutic), 7 patients had level IIb positive for metastases (10...
September 2016: Indian Journal of Surgical Oncology
Anas Abdallah, Murad Asilturk, Mustafa Levent Uysal, Erhan Emel, Betül Guler Abdallah, Bilge Bilgic, Gokcen Gundogdu
AIM: Primary intracranial germinomas (PIGs) are rare malignant brain tumors that represent approximately 0.2% to 1.7% of all primary intracranial tumors. PIGs have infrequent, but existent possibility of spinal cord metastases. In this study, clinical outcomes of five consecutive PIGs have been presented. MATERIAL AND METHODS: Medical records were retrospectively reviewed in 1,849 cases of intracranial tumors whom underwent surgery between the years 2005 and 2015, cases which confirmed as germinoma histopathologically were included in this study...
August 23, 2016: Turkish Neurosurgery
Caroline Clausen, Benny Dahl, Susanne Christiansen Frevert, Julie Lyng Forman, Michael Bachmann Nielsen, Lars Lönn
BACKGROUND: Preoperative embolization is based on the preoperative digital subtraction angiography (DSA) tumor blush, and as such is considered the "gold standard" for determining tumor vascularity. However, to our knowledge reliability studies evaluating vascularity ratings of DSA tumor blush in spinal metastases have not been published previously. PURPOSE: To evaluate inter- and intra-rater agreement in the assessment of the vascularity of spinal metastases using DSA tumor blush...
September 20, 2016: Acta Radiologica
Pedro David Delgado-López, Antonio Rodríguez-Salazar, Vicente Martín-Velasco, José Manuel Castilla-Díez, Javier Martín-Alonso, Ana Galacho-Harriero, Cecilia Gil-Polo, Elena Araus-Galdós
OBJECTIVE: To describe the specific surgical details and report the lessons learned with a series of patients suffering from spinal tumours that underwent total en bloc spondylectomy (TES). METHODS: A retrospective case series review is presented, together with an analysis of the clinical and technical variables, as well as the outcomes. RESULTS: A total of 10 patients underwent TES (2000-2016) for primary (osteosarcoma, chondrosarcoma, fibrosarcoma and chordoma) and secondary spinal tumours (lung, breast, thyroid, oesophagus, and meningioma metastases)...
September 14, 2016: Neurocirugía
Mara Bozza Stephenson, Bryan Glaenzer, Angelo Malamis
Spinal metastases are a common and morbid condition in America. Of the 1.6 million new cases of cancer estimated to be diagnosed in the USA in 2015, approximately 5-10 % will develop spinal metastases. This number is expected to increase as the life expectancy of cancer patients increases. Patients with osteolytic spinal metastases experience severe and often debilitating pain, which significantly reduces quality of life. Due to the morbidity of open surgery, particularly in oncologic patients, the treatment paradigm has shifted towards minimally invasive therapy...
November 2016: Current Treatment Options in Oncology
Masatoshi Yunoki, Kenta Suzuki, Atsuhito Uneda, Kimihiro Yoshino
BACKGROUND: Olfactory neuroblastoma (ONB) is a rare, aggressive tumor of the nasal cavity. It may invade the paranasal cavities and anterior skull base locally but may also metastasize to the cervical lymph nodes, lungs, or distant central nervous system. CASE DESCRIPTION: Here, we report a case of ONB in which emergency surgery was performed for intradural spinal metastasis (ISM). The patient was a 52-year-old male who underwent surgery for ONB. The tumor extended from the nasal cavity to the intracranial space and was resected completely...
2016: Surgical Neurology International
G Abi Lahoud, S Abi Jaoude
The spine is the most common site of skeletal metastases. Treatment decisions for patients with spinal metastases can be challenging and greatly depend on survival prognosis. Surgery remains a valuable weapon in the therapeutic arsenal. A review of the literature describing the role of surgery, the various surgical approaches and the prognostic scores available for the management of spinal metastases was performed and summarized. Surgery for spinal metastases has 3 main objectives: management of pain, achievement of mechanical stability and preservation or restoration of neurological function...
October 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
J C Faivre, J F Py, G Vogin, G Martinage, J Salleron, P Royer, N Grandgirard, D Pasquier, S Thureau
Analgesic external beam radiation therapy is a standard of care for patients with uncomplicated painful bone metastases and/or prevention of bone complications. In case of fracture risk, radiation therapy is performed after surgery in a consolidation of an analgesic purpose and stabilizing osteosynthesis. Radiotherapy is mandatory after vertebroplasty or kyphoplasty. Spinal cord compression - the only emergency in radiation therapy - is indicated postoperatively either exclusively for non surgical indication...
October 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
R A Atkinson, J Stephenson, A Jones, K J Ousey
OBJECTIVE: This study aimed to determine the rate of surgical site infection (SSI) in patients undergoing surgery for spinal metastases, and identify key risk factors for SSI among this patient group. METHOD: A retrospective case note review was undertaken in adult patients being treated at a single specialist centre for spinal surgery. RESULTS: There were 152 patients identified for inclusion. Overall SSI rate was 11.2 per 100 patients (9...
September 2016: Journal of Wound Care
Aymeric Amelot, Alexis Moles, Joseph Cristini, Celine Salaud, Cyrille Touzeau, Olivier Hamel, Eric Bord, Kevin Buffenoir
BACKGROUND: Multiple myeloma (MM) is the most common primary malignant tumor of the spine and bone. Spinal metastases are part of the evolution and progression of the MM disease. Therefore, this study aims at investigating prognostic factors associated with overall survival (OS) in patients with symptomatic spine MM metastases. METHODS: Consecutive spine surgery procedures were performed in the largest series reported to date and comprising 51 patients with osteolytic vertebral compression fractures resulting from MM, diagnosed by either bone marrow or tumor biopsy...
September 2016: Surgical Oncology
Mehmet Hüseyin Akgul, Ferruh Gezen, Ali Kemal Uzunlar
OBJECTIVE: Esthesioneuroblastoma accounted for only 6% of the malignant nasal cavity neoplasms (ENB) is a rare tumor which originates from the olfactory epithelium. ENB's are locally agresive and can metastasize by lymphatic and hematogenous routes. A patient with the mass on the nasal dorsum was reported in this article. CASE HISTORY: A 52-year-old-man admitted to the hospital with a 3 months history of progressive nasal obstruction, epistaxis and mass on the nasal dorsum...
2016: International Journal of Surgery Case Reports
Brenton Pennicooke, Ilya Laufer, Arjun Sahgal, Peter P Varga, Ziya L Gokaslan, Mark H Bilsky, Yoshiya J Yamada
STUDY DESIGN: Systematic literature review. OBJECTIVE: To assess the toxicity, common radiation doses, and local control (LC) rates of radiation therapy for chordoma of the spine and sacrum and identify the difference in LC and toxicity between adjuvant, salvage, and primary therapy using radiation. SUMMARY OF BACKGROUND DATA: Chordoma of the spine is typically a low-grade malignant tumor thought to be relatively radioresistant with a high rate of local recurrence and the potential for metastases...
October 15, 2016: Spine
Farhaan Altaf, Michael Weber, Nicolas Dea, Stefano Boriani, Christopher Ames, Richard Williams, Jorrit-Jan Verlaan, Ilya Laufer, Charles G Fisher
STUDY DESIGN: Systematic review and consensus expert opinion. OBJECTIVE: To provide surgeons and other health care professionals with guidelines for surgical reconstruction of metastatic spine disease based on evidence and expert opinion. SUMMARY OF BACKGROUND DATA: The surgical treatment of spinal metastases is controversial. Specifically two aspects of surgical reconstruction are addressed in this study: (i) choice of bone graft used during surgery for metastatic spine tumors and (ii) the design of reconstruction or construct to stabilize...
October 15, 2016: Spine
Avin Yaldo, Lonnie Wen, Augustina Ogbonnaya, Adriana Valderrama, Jonathan Kish, Michael Eaddy, Charles Kreilick, Krishna Tangirala, Katarzyna Shields
PURPOSE: The development of skeletal-related events (SREs) (pathologic fracture, need for surgery and/or radiation to bone, spinal cord compression, and hypercalcemia of malignancy) in metastatic prostate cancer (MPC) is associated with worsened pain and compromised quality of life. Opioids are frequently used throughout the course of SRE treatment. This study describes the treatment patterns and incremental use of opioids in MPC patients diagnosed with SREs. METHODS: PC patients with bone metastases newly diagnosed with an SRE between January 1, 2005, and September 30, 2014, were identified using MarketScan Commercial and Medicare databases...
August 2016: Clinical Therapeutics
Dara Bakar, Joseph E Tanenbaum, Kevin Phan, Vincent J Alentado, Michael P Steinmetz, Edward C Benzel, Thomas E Mroz
OBJECTIVE The aim of this study was to systematically review the literature on reported outcomes following decompression surgery for spinal metastases. METHODS The authors conducted MEDLINE, Scopus, and Web of Science database searches for studies reporting clinical outcomes and complications associated with decompression surgery for metastatic spinal tumors. Both retrospective and prospective studies were included. After meeting inclusion criteria, articles were categorized based on the following reported outcomes: survival, ambulation, surgical technique, neurological function, primary tumor histology, and miscellaneous outcomes...
August 2016: Neurosurgical Focus
Rory J Petteys, Steven M Spitz, C Rory Goodwin, Nancy Abu-Bonsrah, Ali Bydon, Timothy F Witham, Jean-Paul Wolinsky, Ziya L Gokaslan, Daniel M Sciubba
OBJECTIVE Renal cell carcinoma (RCC) frequently metastasizes to the spine, causing pain or neurological dysfunction, and is often resistant to standard therapies. Spinal surgery is frequently required, but may result in high morbidity rates. The authors sought to identify prognostic factors and determine clinical outcomes in patients undergoing surgery for RCC spinal metastases. METHODS The authors searched the records of patients who had undergone spinal surgery for metastatic disease at a single institution during a 12-year period and retrieved data for 30 patients with metastatic RCC...
August 2016: Neurosurgical Focus
Hesham Mostafa Zakaria, Azam Basheer, David Boyce-Fappiano, Erinma Elibe, Lonni Schultz, Ian Lee, Farzan Siddiqui, Brent Griffith, Victor Chang
OBJECTIVE Predicting the survival rate for patients with cancer is currently performed using the TNM Classification of Malignant Tumors (TNM). Identifying accurate prognostic markers of survival would allow better treatment stratification between more aggressive treatment strategies or palliation. This is especially relevant for patients with spinal metastases, who all have identical TNM staging and whose surgical decision-making is potentially complex. Analytical morphometrics quantifies patient frailty by measuring lean muscle mass and can predict risk for postoperative morbidity after lumbar spine surgery...
August 2016: Neurosurgical Focus
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