ABSTRACT

Primary tumors of the spine are rarely seen. When they are located on the body or posterior elements, the patient first complains of back ache. After an appropriate diagnostic evaluation, the next step would be preoperative planning using modem imaging techniçues. The modalities for proper treatment are complete surgical removal, instrumentation and fusion if instability is caused, adjuvant or neoadjuvant chemo and/or radiotherapy and embolisation.

Between 1990 and 1995, at the department of Orthopaedics and Traumatology, İstanbul medica! faculty, we have surgicaily treated 26 patients with primary spı'nal bone tumors. The histopathologic diagnosis of the patients are; chordoma (3), chondrosarcoma (2), primary epitheloid sarcoma (1), giant celi tumor (2), eosinophilic granuloma (2), primary bone lymphoma (1), aneurysmal bone tumor (2), osteochondroma (1), fibrous dysplasia (1), osteoid osteoma (6) and osteoblastoma (5). Ali of the patients have been preoperativeiy evaluated using conventional radiography, computerized tomography, MRI, Tc99 bone scintigraphy and angiography when required. The most important factors influencing the surgical strategy are histopathologic diagnosis, anatorhic localization and blood supply of the mass.

A well vascularized giant celi tumor on LV5 has fully disappeared after embolisation and another at the same localization has shrinked to a very small volüme making the surgical intervention quite easy. Ali the masses have been totally removed using posterior and/or anterior route. Five operations resulted with instability of the spinal column and fusion with instrumentation has been added. We have neither seen any early or late complications nor any local recurrences.

Primary tumors of the spine can be successfully treated using modern, sophisticated preoperative imaging techniques and the aid of preoperative embolisation.