Surgical treatment of the metastatic cervical spine tumours

Czech version

Authors: P. Barsa; P. Suchomel
Authors‘ workplace: Neurochirurgické oddělení, Neurocentrum, Krajská nemocnice Liberec
Published in: Cesk Slov Neurol N 2007; 70/103(1): 16-22
Category: Review Article

Overview

A spinal decompression followed by reconstruction and stabilization represents an effective strategy in the management of cervical spinal metastases in selected patients. Various techniques available in armamentarium are discussed in this overview. Because of predominant anterior spinal column metastatic involvement the consideration is given to the vertebral body replacement techniques. In oncological patients, numerous factors play against the optimal surgical result that is the bone fusion facilitated by an autologous bone graft or substitutes. The aim of modern anterior reconstruction is superior primary stability in order to permit an early rehabilitation and ambulation in the rest of life. In patiens with short-term life expectancy, the reconstruction with PMMA supplemented by an appropriate internal fixation achieves immediate stability. Titanium meshed interbody cages represent an alternative to PMMA when mid-term survival is anticipated. The appropriate sizing of the cage to the defect is of paramount importace in order to obtain superior primary stability of the construct. Therefore distractable telescopic spacers seem to be ideal in this indication.

Key words:
metastasis, spine tumour, spinal instrumentation, vertebral body replacement.

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