Posterior internal-fixation combined with iodine-125 interstitial brachytherapy in the treatment of spinal metastastic tumors

English Keywords:Spinal metastatic tumor  Brachytherapy  Iodine-125 seeds  Posterior spinal fixation

English Abstract:

  【Abstract】 Objective：To evaluate the preliminary results of posterior internal-fixation combined with iodine-125（125I） interstitial brachytherapy in the treatment of spinal metastatic tumors.Method：From July 2004 to March 2008，17 cases with spinal metastatic tumors who had spinal instability and intractable back pain or nerve root pain and were not suitable for tumor resection underwent 125I seeds implantation under the guidance of C-arm fluoroscopy after posterior internal-fixation to reconstruct the spinal stability.Result：The time of follow-up was 7-39 months averaged 21.3 months.The effect was revealed 3-26 days after the operation.12 cases had complete pain relief（VAS scores <20mm），3 cases had partial pain relief（VAS scores were between 20-40mm）.2 cases had no pain relief（VAS scores >40mm）.8 of 11 cases who presented neurological dysfunction showed a good recovery，but 2 cases had no change at all and 1 case became wrose.2 cases died of hepatic failure at 7th and 8th months respectively after operation.One case died of multiple organs failure （MOF） 15 months later.The other 14 cases were alive at the final follow-up.The tumor growth was restrained and no recurrence of vertebral metastasis was found in 5 cases.Conclusion：Posterior internal-fixation for reconstruction of spinal stability combined with 125I interstitial brachytherapy is a good alternative for the treatment of spinal metastatic tumors which lead to spinal instability and intractable pain，or are unresectable.It can relieve pain，restrain the growth of tumor，and avoid losing spinal stability.