medigraphic.com
ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2025, Number 1

<< Back

Acta Ortop Mex 2025; 39 (1)

Is the use of total vertebrectomy justified for single vertebral metastases? Presentation of one clinical case and review of the literature

Portes-Chiva A, Isart-Torruela A, Vila-Canet G, Arco-Churruca A, Rodríguez-Rubio D, Manzano-López D, Lafuente-Baraza J, Saló-Bru G

Language: Spanish
References: 22
Page: 52-57
PDF size: 517.15 Kb.


ABSTRACT

Introduction: the indication for total vertebrectomy in single vertebral metastases is increasingly questioned, especially in metastases with unknown primary tumour. Material and methods: in this article we describe a case of vertebral metastasis of unknown primary tumour treated by total vertebrectomy, and a review of the literature. Results: in those patients with a good general condition, single vertebral metastases and no involvement of internal organs, as in our case, curative surgical treatment can be considered with total vertebrectomy being the treatment of choice in lesions that only affect the body of the vertebra. Conclusions: total vertebrectomy may be a therapeutic alternative in patients with primary tumours or single vertebral metastases, but the high rate of associated complications should not be underestimated.


REFERENCES

  1. Ma Y, He S, Liu T, Yang X, Zhao J, Yu H, et al. Quality of life of patients with spinal metastasis from cancer of unknown primary origin: a longitudinal study of surgical management combined with postoperative radiation therapy. J Bone Joint Surg Am. 2017; 99(19): 1629-1639. doi: 10.2106/JBJS.16.00286.

  2. Verlaan JJ, Choi D, Versteeg A, Albert T, Arts M, Balabaud L, et al. Characteristics of patients who survived < 3 months or > 2 years after surgery for spinal metastases: can we avoid inappropriate patient selection? J Clin Oncol. 2016; 34(25): 3054-61. doi: 10.1200/JCO.2015.65.1497.

  3. Wright E, Ricciardi F, Arts M, Buchowski JM, Chung CK, Coppes M, et al. Metastatic spine tumor epidemiology: comparison of trends in surgery across two decades and three continents. World Neurosurg. 2018; 114: e809-e817. doi: 10.1016/j.wneu.2018.03.091.

  4. Douglas S, Huttenlocher S, Bajrovic A, Rudat V, Schild SE, Rades D. Prognostic factors for different outcomes in patients with metastatic spinal cord compression from cancer of unknown primary. BMC Cancer. 2012; 12: 261. doi: 10.1186/1471-2407-12-261.

  5. Tokuhashi Y, Ajiro Y, Umezawa N. Outcome of treatment for spinal metastases using scoring system for preoperative evaluation of prognosis. Spine (Phila Pa 1976). 2009; 34(1): 69-73. doi: 10.1097/BRS.0b013e3181913f19.

  6. Kato S, Murakami H, Demura S, Yoshioka K, Ota T, Shinmura K, et al. Patient and family satisfaction with en bloc total resection as a treatment for solitary spinal metastasis. Orthopedics. 2013; 36(11): e1424-30. doi: 10.3928/01477447-20131021-27.

  7. Tomita K, Kawahara N, Murakami H, Demura S. Total en bloc spondylectomy for spinal tumors: improvement of the technique and its associated basic background. J Orthop Sci. 2006; 11(1): 3-12. doi: 10.1007/s00776-005-0964-y.

  8. Tokuhashi Y, Matsuzaki H, Oda H, Oshima M, Ryu J. A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976). 2005; 30(19): 2186-2191. doi: 10.1097/01.brs.0000180401.06919.a5.

  9. Tomita K, Kawahara N, Kobayashi T, Yoshida A, Murakami H, Akamaru T. Surgical strategy for spinal metastases. Spine (Phila Pa 1976). 2001; 26(3): 298-306. doi: 10.1097/00007632-200102010-00016.

  10. Paulino-Pereira NR, Janssen SJ, van Dijk E, Harris MB, Hornicek FJ, Ferrone ML, et al. Development of a Prognostic Survival Algorithm for Patients with Metastatic Spine Disease. J Bone Joint Surg Am. 2016; 98(21): 1767-1776. doi: 10.2106/JBJS.15.00975.

  11. Culine S, Kramar A, Saghatchian M, Bugat R, Lesimple T, Lortholary A, et al. Development and validation of a prognostic model to predict the length of survival in patients with carcinomas of an unknown primary site. J Clin Oncol. 2002; 20(24): 4679-4683. doi: 10.1200/JCO.2002.04.019.

  12. Barzilai O, Boriani S, Fisher CG, Sahgal A, Verlaan JJ, Gokaslan ZL, et al. Essential concepts for the management of metastatic spine disease: what the surgeon should know and practice. Global Spine J. 2019; 9(1 Suppl): 98S-107S. doi: 10.1177/2192568219830323.

  13. Delank KS, Wendtner C, Eich HT, Eysel P. The treatment of spinal metastases. Dtsch Arztebl Int. 2011; 108(5): 71-79. doi: 10.3238/arztebl.2011.0071.

  14. Bartels RH, van der Linden YM, van der Graaf WT. Spinal extradural metastasis: review of current treatment options. CA Cancer J Clin. 2008; 58(4): 245-259. doi: 10.3322/CA.2007.0016.

  15. Rades D, Fehlauer F, Veninga T, Stalpers LJ, Basic H, Hoskin PJ, et al. Functional outcome and survival after radiotherapy of metastatic spinal cord compression in patients with cancer of unknown primary. Int J Radiat Oncol Biol Phys. 2007; 67(2): 532-537. doi: 10.1016/j.ijrobp.2006.08.047.

  16. Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res. 1980; (153): 106-120.

  17. Amendola L, Cappuccio M, De Iure F, Bandiera S, Gasbarrini A, Boriani S. En bloc resections for primary spinal tumors in 20 years of experience: effectiveness and safety. Spine J. 2014; 14(11): 2608-2617. doi: 10.1016/j.spinee.2014.02.030.

  18. Tomita K, Toribatake Y, Kawahara N, Ohnari H, Kose H. Total en bloc spondylectomy and circumspinal decompression for solitary spinal metastasis. Paraplegia. 1994; 32(1): 36-46. doi: 10.1038/sc.1994.7.

  19. Cloyd JM, Acosta FL Jr, Polley MY, Ames CP. En bloc resection for primary and metastatic tumors of the spine: a systematic review of the literature. Neurosurgery. 2010; 67(2): 435-444. doi: 10.1227/01.NEU.0000371987.85090.FF.

  20. Boriani S, Bandiera S, Biagini R, Bacchini P, Boriani L, Cappuccio M, et al. Chordoma of the mobile spine: fifty years of experience. Spine (Phila Pa 1976). 2006; 31(4): 493-503. doi: 10.1097/01.brs.0000200038.30869.27.

  21. Sakaura H, Hosono N, Mukai Y, Ishii T, Yonenobu K, Yoshikawa H. Outcome of total en bloc spondylectomy for solitary metastasis of the thoracolumbar spine. J Spinal Disord Tech. 2004; 17(4): 297-300. doi: 10.1097/01.bsd.0000096269.75373.9b.

  22. Boriani S, Bandiera S, Donthineni R, Amendola L, Cappuccio M, De Iure F, et al. Morbidity of en bloc resections in the spine. Eur Spine J. 2010; 19(2): 231-241. doi: 10.1007/s00586-009-1137-z.




2020     |     www.medigraphic.com