E-ISSN: 2147-5903
THE EFFECT OF TOTAL EXCISION OF TUMOR, ANTERİOR STRUT GRAFTING AND ANTERIOR OR POSTERIOR INSTRUMENTATION ON LIFE QUALITY OF THE PATIENTS WITH THORACIC AND LUMBAR METASTATIC SPINAL TUMOR
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Original Article
VOLUME: 18 ISSUE: 3
P: 3-16
July 2007

THE EFFECT OF TOTAL EXCISION OF TUMOR, ANTERİOR STRUT GRAFTING AND ANTERIOR OR POSTERIOR INSTRUMENTATION ON LIFE QUALITY OF THE PATIENTS WITH THORACIC AND LUMBAR METASTATIC SPINAL TUMOR

J Turk Spinal Surg 2007;18(3):3-16
Alper KAYA 1
Alpaslan ŞENKÖYLÜ 2
Berk GÜÇLÜ 3
Murat KÖKEN 4
İ. Teoman BENLİ 5
1. Yrd. Doç. Dr., Ortopedi ve Travmatoloji Uzmanı, Ufuk Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Ankara.
2. Yrd. Doç. Dr., Ortopedi ve Travmatoloji Uzmanı, Gazi Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Ankara.
3. Ortopedi ve Travmatoloji Uzmanı, Ufuk Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Ankara.
4. Araştırma Görevlisi, Ufuk Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Ankara.
5. Prof. Dr, Ortopedi ve Travmatoloji Uzmanı, Ufuk Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Ankara.
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ABSTRACT

Vertebrae is one of the most common locati-on of malign tumor metastases according to its vascularity and neighborhood with internal or-gans. Refractory pain and neurological deficits caused by the pathologic fractures followed by the destruction of the vertebral body according to metastatic tumors, negatively effects the pati-ents life quality. In this study, surgical treatment results of 40 patients with metastatic vertebra tumors, mean age 51.4 (21-78), evaluated retros-pectively. Patients were classified according to Tomita classification, and Tokuhashi prognostic scoring was used for surgical planning. Anterior total excision of tumor mass, anterior strut graf-ting and anterior or posterior instrumentation at the same stage performed for all patients beca-use of the anterior corpus location of the tumors and the Tokuhashi score, that was mean 9.3. Oswestry Disability Index (ODI) was used for cli-nical evaluation and Frankel classification was used for neurological evaluation. The most common etiologic cause was pulmoner carsinoma metastasis with 24 patients (60 %) and followed by breast, gastrointestinal system and thyroid cancer metastasis. Neurologic deficit was obta-ined in 31 patients preoperatively, and all patients hadparsiel or total neurologic recovery pos-toperatively. When all patients included, the ODI score increased from 22.3 ± 24.4 to 55.8 ± 9,9 postoperatively, that was statisticaly significant (p<0.05). At the last visits, when all patients included, it was observed that the ODI score was decreased to 49.8 ± 6,6. Whereas only 4 patients (10 %) were ambulatory preoperatively, 36 patients (90 %) were ambulatory postoperatively and the ambulatory patient number was keeped at the last visits. It was determined that solid fu-sion mass developed in all patients and there were not any early or late neurological deficit, lo-cal or systemic complications. According to the datas of this study, its concluded that, wide tumor excision, anterior strut grafting, anterior or posterior instrumentation positively effects the patients life quality in metastatic vertebra tumors although effectiveness on lifetime.

Keywords:
Metastatic spinal tumors, total excision of tumor, surgical treatment, instrumen-tation.