COMPARATIVE ANALYSIS OF SURGICAL METHODS FOR THE TREATMENT OF METASTATIC SPINE TUMORS

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Abstract

An analysis of the literature data showed that primary spinal tumors are rare; in most cases, spinal tumors are secondary, i.e. metastatic. Among them, hemangiomas, myelomas and metastases of uterine cancer predominate. Purpose of the work - to study the effectiveness of various surgical interventions taken in case of tumor lesions of the spine. Material and methods. Case histories of 23 patients who were treated in the neurosurgical department of ASMI clinics and the neurosurgical department of the AF RNCEM in 2005-2007 served as material for a comparative analysis of the effectiveness of surgical methods of treatment. The age of patients is from 18 to 50 years, the duration of the disease is from 1 to 3 years. There were 16 men and 7 women. Results and discussion. In the immediate postoperative period, 17 patients had complete disappearance of pain syndrome, 4 had a significant decrease in their intensity, and 2 patients had pains that remained at the preoperative level. Regression of neurological disorders in the postoperative period was observed in 18 operated patients. Positive clinical and neurological dynamics in the immediate postoperative period occurred in 80-85% of patients in both groups. However, over time, with a re-examination after 6 months and 1 year, the percentage of patients with a positive result of the 1st group decreased to 30-40%.


In the 2nd group, the number of patients with positive neurological changes and the bearing capacity of the bodies of the affected vertebrae remained at the same levels - 75 - 80%.

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List of references

Enneking W.E., Spanier S.S., Goodman M.A. A System for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res 1980;(153):106–20.

Tomasian A., Wallace A.N., Jennings J.W. Benign spine lesions: advancesin techniques for minimally invasive percutaneous treatment. Am J Neuroradiol 2017;38(5):852–61. DOI: 10.3174/ajnr.A5084.

Wang B., Meng N., Zhuang Н. et al. The role of radiotherapy and surgery in the management of aggressive vertebral hemangioma: a retrospective study of 20 patients. Med Sci Monit 2018;24:6840–50. DOI: 10.12659/ MSM.910439.

Laredo J.D., Reizine D., Bard M., Merland J.J. Vertebral hemangiomas: radiologic evaluation. Radiology 1986;161(1):183–9. DOI: 10.1148/radiology.161.1.3763864.

Климов В.С., Косимшоев М.А., Евсюков А.В и др. Результаты дифференцированного хирургического лече ния агрессивных гемангиом позвонков. Хирургия позвоночника 2018;15(1):79–90. [Klimov V.S., Kosimshoev M.A., Evsyukov A.V. et al. Results of differentiated surgical treatment of aggressive vertebral hemangiomas. Hirurgia Pozvonocnika = Spine Surgery 2018;15(1):79–90. (In Russ.)]. DOI: http://dx.doi.org/10.14531/ ss2018.1.79-90.

Vasudeva V.S., Chi J.H., Groff M.W. Surgical treatment of aggressive vertebral hemangiomas. Neurosurg Focus 2016;41(2):E7. DOI: 10.3171/2016.5.FOCUS16169.

Parker J., Soltani S., Boissiere L. et al. Spinal aneurysmal bone cysts (ABCs): optimal management. Orthop Res Rev 2019;11:159–66. DOI: 10.2147/ORR.S211834.

Tsagozis P., Brosjo O. Current strategies for the treatment of aneurysmal bone cysts. Orthop Rev (Pavia) 2015;7(4):6182. DOI: 10.4081/or.2015.6182.

Aiba H., Kobayashi1 M., WaguriNagaya Y. et al. Treatment of aneurysmal bone cysts using endoscopic curettage. BMC Musculoskelet Disord 2018;19(1):268. DOI: 10.1186/s12891-018-2176-6. 20. Li G., Fu D., Chen K. et al. Surgical strategy for the management of sacral giant cell tumors: a 32-case series. Spine J 2012;12(6):484–91. DOI: 10.1016/j.spinee.2012.06.014.

Martin С., McCarthy E.F. Giant cell tumor of the sacrum and spinе: series of 23 cases and review of the literature. Iowa Orthop J 2010;30:69–75.

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