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57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

11. bis 14.05.2006, Essen

Complications and perioperative outcome in spinal surgery for vertebral metastasis

Komplikationen und perioperativer klinischer Verlauf in der spinalen Chirurgie der Wirbelkörpermetastasen

Meeting Abstract

  • corresponding author F. Rommel - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf
  • M. Messing-Jünger - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf
  • M. Klingenhöfer - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf
  • J. Herdmann - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocSA.07.06

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Veröffentlicht: 8. Mai 2006

© 2006 Rommel et al.
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Objective: The general opinion about the treatment of spinal metastasis has long been influenced by the study of Young et al. published in 1980 which showed no significant difference in neurological outcome between radiation therapy and laminectomy. Laminectomy enhances instability of the spine impeding early mobilization. Today early decompression, reconstruction and stabilization allowing early mobilization and rehabilitation is a well accepted strategy in spinal trauma. It was postulated that these benefits can prevent complications of long-term immobility and thus allow contempory oncological treatment in patients suffering from spinal metastasis.

Methods: We analysed the data of 75 patients suffering from spinal metastasis of various types, who had been treated surgically in our clinic. In 12,2% the cervical, in 31,1% the thoracic and in 18,9% the lumbar spine was affected. Breast cancer was the most frequent primary tumor (26,7) followed by carcinomas of the lung (21,3) and prostate cancer (6,7). Surgical techniques were ventral corporectomy, reconstruction by titanium mesh and plating in the cervical spine. Posterior approaches included decompression by laminectomy, dorsolateral vertebrectomy and recontruction with titanium mesh or PMMA and always posterior stabilization.

Results: Intraoperative complications were very rare (1,3%). Postoperative complications were observed in 33,3% of the patients but only 4% of patients suffered from severe complications like pulmonary embolism or cardiac arrhythmia. The most frequent complication was superficial wound infection in 10,7% of patients. All patients could be discharged for further oncological treatment. Non of the patients died due to surgery. Pre-operative ASIA-score could be improved in 12% of patients, only in 2,7% of cases ASIA-score deteriorated.

Conclusions: Vertebrectomy, reconstruction and stabilization was a save procedure in our patients with spinal metastasis. The major complication was wound infection which could be safly managed surgically and medically. Neurological deterioration was observed in less than 3% and fare more frequently neurological improvement could be achieved.