Surgical Treatment of Spinal Tumors

Orlov V., Dulaev ., Alekseev .

Medicomilitary Academy, Saint Petersburg, Russia

 

The authors have an experience of surgical treatment of 56 cases (29 males and 27 females) with spinal tumors. All the patients were divided into the following groups, based on clinical entities: metastatic lesions of vertebral bodies - 38 (67.9%), hemangiomas - 4 (7.1%), lesions of the vertebral column in multiple myeloma - 8 (14.3%), chondromas - 3 (5.3%), giant cell tumor - 3 (5.3%). Indications for an operation were as follows: presence and progression of neurological disorders, pathologic fractures of vertebral bodies, a quick growth of tumor with a high risk of development of neurological disorders or a pathologic fracture. The cases were subjected to corporectomy with tumor removal and anterior spondylodesis with an autotransplant (37 cases; 66.1%), laminectomy (9 cases; 16.1%). The vertebral column was stabilized with the help of distractors (13 cases; 23.2%), a distractor-contractor combination (27 cases; 48.2%), transpedicular fixation (14 cases; 25.0%), worn Z-type plates (12 cases, 21.4%). Good anatomic and functional results were obtained in 8 patients with benign spinal tumors; there were no relapses. The rest 2 cases with benign tumors of vertebral bodies developed recurrences, which demanded repeated interventions. Decompressive-stabilizing and stabilizing interventions on the spine, combined with rational chemo- and radiotherapy, led to considerable improvement of life quality in 33 out of 38 cases.