Surgical treatment and outcome of thoracic spinal metastasis

English Keywords:Thoracic vertebra metastases tumors  Surgery  Survival time  Total en bolc spondylectomy

English Abstract:

  【Abstract】 Objectives: To discuss the surgical treatment and outcome of thoracic spine metastatic.tumors. Methods: From July 2005 to December 2009, 40 patients with thoracic metastatic tumors undergoing surgery were analyzed. These included 27 males and 13 females with an average age of 58.8 years(range 23-79). The primary tumor included 11 pulmonary carcinomas, 8 mammary adenocarcinomas, 6 renal carcinomas, 4 thyroid carcinomas, 3 esophageal carcinomas, 3 hepatic carcinomas, 1 carcinoma of bladder, 1 adipose sarcoma, 1 carcinoma of gastric cardia, 1 chondrosarcoma and 1 prostatic carcinoma. The Frankel grade was A in 7, B in 3, C in 10, D in 15, E in 5. The surgical methods included anterior corpectomy and fixation in 26 cases(lesions located at zone 4-9 by WBB classfication, average Tomita prognostic score of 5.5, range 4-6), posterior approach in 5 cases(lesions located at zone 1-3 or 10-12 by WBB classfication, average Tomita prognostic score of 7.0, range 6-8), combined anterior and posterior approach in 4 cases(lesions located at one or two vertebral bodies, average Tomita prognostic score of 4.0, range 3-5), posterior decompression and stabilization with percutaneous vertebroplasty in 5 cases(lesions located at zone 4-9 by WBB classification in multiple vertebral bodies, average Tomita prognostic score of 7.6, range 6-8). Clinical outcome was observed during follow-up. Results: Follow-up was obtained in 40 cases with a mean value of 12.4 months(range 6-36 months), 25 patients died and the mean life span was 10.7 months(range 6-20). The postoperative Frankel grade changed significantly and ended up with A in 1, B in 3, C in 3, D in 8 and E in 25. The average preoperative VAS score was 6.81±1.51, which decreased to 3.65±0.94(P<0.05). Conclusions: The surgical approach can improve the life quality of patients with thoracic spine metastasis, the patients′ general condition and tumors′ stage should be considered when choosing surgical techniques.