Surgical treatment of atlantoaxial metastases：a retrospective study

English Keywords:Metastasis  Atlantoaxial spine  Surgery

English Abstract:

  【Abstract】 Objective：To evaluate the results and contribution of surgical treatment for atlantoaxial metastases.Method：A total of 22 inpatients diagnosed with atlantoaxial metastatic tumors from June，2001 to August，2008 were reviewed retrospectively.All patients were classified into the surgery group and the conservative treatment group and the former was subgrouped into 125I Seed brachytherapy combined with craniocervical instrumentation group and other surgical group based on surgical protocols.The mean survival，surgical outcome and life quality between each group were compared.Result：Of 22 cases，17 patients（77.3%） had been followed up.7 patients in 125I seed brachytherapy group，4 patients in other surgery group （craniocervical instrumentation/Halo-vest immobilization） and 6 patients in conservative treatment group.The mean survival time for three groups was 48.0±27.0 months，22.0±8.3 months and 6.0±1.2 months respectively，which showed statistical significance（P＜0.05）.Patients in surgery group had neck pain relieved and life quality improved significantly after an average of 24.8 days in hospital periods.Visual analog scale for neck pain reduced from 8.4 points to　3.0 points；Karnofsky performance score increased from　65.5 points to 79.1 points，both had statistical significance（P＜0.05）.Conclusion：For atlantoaxial metastases complicated with stability impairment，posterior craniocervical instrumentation can reconstruct stability and improve the life quality，while this protocol combined with 125I seed brachytherapy can simultaneously kill tumor cells continuously which is aimed to control local recurrence.