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At least 19 recordsLinked to original sources
PubMed2005

[The surgical palliation of operation combined with vertebroplasty for multiple spinal neoplasm].

OBJECTIVE: To discuss the effect and complication of spinal operation combined with vertebroplasty in treating for multiple spinal neoplasm. METHODS: During the last two years, 20 patients (13 male and 7 female) with multiple spinal neoplasm including metastases, multiple myeloma and lymphoma were treated by operation combined with vertebroplasty, 2 vertebral body segments were involved in 5 cases, 3 to 4 vertebral body segments were involved in 11 cases, more than 5 segments were involved in other 4 cases. Neurological function deficit and severe pain were seen in all the cases. Patients were evaluated by Tomita prognostic scoring system before the operation; The average point was 7.2 (from 3 to 9 points). RESULTS: The pain relief rate was 85% (17/20), and neurological recovery was found in 10 out of 12 patients who had neurological deficit. According to the system of Frankel and neurological function, 1 patient recovered from grade B to grade C after the operation, and there was no change in another patients who was evaluated as grade A before the operation. The main complication of vertebroplasty was leakage of PMMA. Six patients had leakage of PMMA into adjacent structures in this series. CONCLUSIONS: Better results of pain relief and neurological function recovery and living quality can be achieved by surgical palliation of operation combined with vertebroplasty for multiple spinal neoplasm.

Adult↗
PubMedDate not supplied

[Benign spinal neoplasms: results of treatment and clinical aspects].

Benign spinal neoplasm (b.s.n.) represented 11% (8 cases) of all histopathologically verified spinal neoplasm in 85 patients operated on between 1975 and 1990. Local back or neck pain were first clinical symptoms of b.s.n. On admission all the patients presented with bone lesions on X-ray plain radiograms of the spine. Surgical management included removal of the tumour and stabilization using bone grafts. Excellent results (complete pain relief and improvement of motor function making the patients ambulatory and independent) were obtained in all the cases. All the patients presented with solid fusion of bone grafts and good spinal stability at the last follow-up.

Adult↗
PubMed2001

Recurrence of benign spinal neoplasms.

The outcome of surgical treatment of benign spinal neoplasms is considered to be excellent, with good improvement of neurological function. The risk of recurrence is estimated to be very low, except with subtotal resections. This retrospective study was designed to establish the course of illness, clinical outcome, and recurrence rate of benign spinal tumours. We present an overview of the clinical outcome and surgical treatment of 197 benign spinal tumours carried out in our centre from 1980 to 1999. Clinical history, signs, surgical approach, outcome, and radiological reports were obtained by reviewing patient charts. The most frequent benign tumour was meningeoma (41%), closely followed by neurinoma (33%) and neurofibroma (6.1%). Of all tumours, 79.7% were completely resected. Recurrence happened in 10.2% on an average of 4.3 years postoperatively. Only 2 patients suffered from neurofibromatosis. All neurinomas were completely resected at first operation, whereas three out of seven recurrent meningeomas and all ependymomas were classified as subtotally resected. Seventy per cent were treated by repeated surgical intervention. Benign tumours usually can be completely removed without adding to patients' neurological deficits. Benign tumours recur in 10.2% of cases, thus requiring long-term follow-up. Magnetic resonance imaging (MRI) studies are recommended up to 5 years postoperatively as a routine procedure.

Adult↗
PubMed1993

Pediatric spinal neoplasms.

Magnetic resonance imaging (MRI) is an accurate and noninvasive tool in the evaluation of children with spinal neoplasm. Localization and definition of site and extent of disease for treatment planning, the most important goals of neuroimaging in spinal neoplastic disease, have become more precise with MRI, because all spinal compartments can be seen without the need for subarachnoid puncture. Epidural and contiguous soft tissue disease, and associated vertebral abnormalities such as marrow replacement by metastatic processes, are readily confirmed during the same examination. In children, as in adults, gadolinium-diethylenetriaminepentaacetic acid aids in separating intramedullary neoplasms from associated edema or syrinx, and is essential in the evaluation of intradural-extramedullary spread of neoplasm. MRI is also useful in the exclusion of compressive lesions in children with systemic neoplasms and cord infarction or treatment-related transverse myelopathy.

Adolescent↗
PubMed2003

Results of preoperative embolization for metastatic spinal neoplasms.

OBJECT: Arterial embolization reduces blood loss in patients undergoing surgery for hypervascular spinal tumors. The objectives of this study were twofold: 1) to evaluate the role of magnetic resonance (MR) imaging in predicting tumor vascularity and 2) to assess the effectiveness of preoperative embolization in devascularizing these tumors. METHODS: Fifty-one patients with metastatic spinal neoplasms underwent angiography, preoperative embolization, and excision of the lesion between 1995 and 2000. The MR imaging studies were correlated with tumor vascularity on angiograms. Embolization was angiographically graded on a five-point scale ranging from no embolization (Grade A) to total embolization (Grade E). The embolization grade was correlated with intraoperative blood loss. The mean age was 57 years, the male/female ratio was 1.2:1, and back pain was present in all patients. Metastatic renal cell carcinoma (30 cases) and thoracic spine involvement (33 cases) were most frequent. The positive predictive value of MR imaging in determining tumor vascularity was 77%, whereas the negative predictive value was 21%. Total embolization (Grade E) was achieved in 34 patients. A shared vascular pedicle between a radiculomedullary artery (RMA) and a tumor diminished the likelihood of complete embolization (p = 0.02). Small asymptomatic cerebellar infarctions were demonstrated in two cases. The mean intraoperative blood loss was 2,586 ml. Following Grade D or E embolization, intraoperative bleeding was largely related to unembolized epidural veins. CONCLUSIONS: Tumor histology and MR imaging findings are predictive of hypervascularity, however, hypervascular tumors may not be detected by standard MR imaging sequences. Superselective catheterization permits Grade D or E embolization in 80% of patients. Shared blood supply with an RMA is the most important factor precluding complete embolization.

Angiography↗
PubMedDate not supplied

[Advances in diagnostic procedures and treatment of spinal neoplasms].

In the years 1958-1995 in the Department of Neurosurgery in Bydgoszcz we treated operatively 160 patients (100 men and 60 women aged 5-81 yrs) with spinal tumours causing spinal cord compression. Our material was useful in estimating the evolution in diagnostic procedures, treatment and limit of contraindications to surgery. We utilized previously analyzed patients' data from the years 1958-1987 (100 patients) and compared this with results from the years 1988-1995 (60 patients). In the years 1988-1995 we operated on twice as many patients per year than in the period 1958-1987 owing to better diagnostic and operative procedures and decrease of contraindications to treatment. In about 60 percent of patients the tumours were totally and subtotally removed. In recent period we performed 10 initial procedures of transpedicular stabilization. In most cases the extensiveness of tumours did not reach the level of three spinal segments. We confirmed good early results of treatment, particularly in cases with total resection of tumours, in about half the patients with spinal neoplasm, although the most common histological diagnoses were carcinoma (89 cases). In thirty percent of cases with carcinoma only pain was diminished.

Adolescent↗
PubMed1988

Gadolinium-DTPA-enhanced MR imaging of spinal neoplasms: preliminary investigation and comparison with unenhanced spin-echo and STIR sequences.

Unenhanced T1- and T2-weighted spin-echo, short inversion time inversion recovery (STIR), and gadolinium-DTPA (Gd-DTPA)-enhanced spin-echo and STIR imaging techniques were used in 20 patients as part of a multicenter study to assess the safety and efficacy of Gd-DTPA in spinal imaging. Five patients had normal MR scans. Of those with lesions, both Gd-DTPA-enhanced T1-weighted spin-echo and unenhanced STIR scans improved detection and evaluation of spinal tumors over conventional spin-echo methods, particularly T2-weighted spin echo, by providing higher tissue contrast in shorter imaging times. The Gd-DTPA-enhanced T1-weighted spin-echo scans were most helpful in evaluating intradural tumors, whereas STIR sequences were most effective for extradural tumors and bone metastases. In most cases, Gd-DTPA-enhanced T1-weighted spin-echo scans best delineated tumor margins, and the enhancement was helpful in suggesting a cellular or active nature of the lesions. In some cases, the enhancement resulted in a more homogeneous and thus less abnormal-appearing marrow in vertebrae involved by tumor; therefore, a precontrast T1-weighted spin-echo scan is necessary in all patients who are to be studied with Gd-DTPA. A combined approach that uses T1-weighted spin-echo, Gd-DTPA-enhanced T1-weighted spin-echo, and STIR images currently appears optimal for MR imaging of spinal neoplasms. T2-weighted spin-echo images add information only in occasional cases.

Bone Marrow↗
PubMedDate not supplied

[On some clinical aspects of extradural spinal neoplasms].

Certain clinical aspects of extradurally situated spinal tumours are presented stressing their importance for the diagnosis and therapeutic approach. The role of pain as the first clinical symptom is emphasized. Of great importance are the plan X-ray films of the spine which in nearly 70% of cases reveal changes in bone structure. On the basis of intraoperative findings three types of infiltration of the tumours are presented, with the method of clinical management depending on this type.

Female↗
PubMedDate not supplied

[Differential diagnosis of benign spinal neoplasms].

The authors analyze problems arising in differential diagnosis of benign spinal tumors not adequately described in available literature. The most characteristic x-ray symptoms of rare spinal tumors are presented. Methods of radiologic investigation such as polipositional roentgenography, tomography, roentgenography with direct image amplification are described in detail. A total of 102 observations of benign spinal tumors are analyzed: osteoblaclastomas responsible for 14.7% of osteoblastoclastomas, angiomas responsible for 66.7% of cases, osteochondroma occurring in 6.7% of cases, chordomas and osteoid ostema occurring in 10.7 and 1.0% of cases, respectively.

Adolescent↗
PubMedDate not supplied

[The role of surgery in comprehensive treatment of spinal neoplasms].

Basing on clinical experience of 212 surgically treated spinal tumours the authors present the principal problems in surgical treatment of neoplasmatic disease of the spine. The essential aim of surgical treatment is the tendency to the radical removal of the tumour and, in the same time, to achieve a good stabilization of the spine. The best method of stabilization of the spine is internal stabilization, transpedicular and interbody. The removed parts of the vertebral column should be replaced with bone grafts. The surgical treatment should be combined with oncological and rehabilitation.

Adult↗
PubMed2002

Endoscopic assisted posterior decompression for spinal neoplasms.

The authors describe a technique for anterior thoracic decompression via a posterolateral approach for spinal metastatic disease followed by anterior and posterior column stabilization. We discuss the benefits of decompression via a posterolateral approach including minimization of cord retraction, avoidance of thoracotomy, early mobilization and shorter hospital stay. Technical details are reviewed and difficulties of the approach discussed.

Decompression, Surgical↗
PubMed1968

Spinal neoplasms.

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Adolescent↗