gms | German Medical Science

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

Limits and possibilities of acute decompressive laminectomy in spinal epidural metastases

Grenzen und Möglichkeiten der akuten dekompressiven Laminektomie bei spinalen epiduralen Metastasen

Meeting Abstract

Suche in Medline nach

  • corresponding author J.M. Lang - Neurochirurgische Abteilung am Landeskrankenhaus Klagenfurt, Klagenfurt/A
  • H. Rauter - Neurochirurgische Abteilung am Landeskrankenhaus Klagenfurt, Klagenfurt/A
  • G. Lanner - Neurochirurgische Abteilung am Landeskrankenhaus Klagenfurt, Klagenfurt/A

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. DocP 12.203

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2006/06dgnc420.shtml

Veröffentlicht: 8. Mai 2006

© 2006 Lang et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: In the 1970th and 80th studies were published reported on successfully (defined as the ability to walk after operation) decompressive laminectomies alone in about 30 % (mean) of patients. Treatment of metastatic spinal epidural disease has undergone changes in the last 20 years. But acute decompressive laminectomy still has its place in neurosurgical daily routine. Though we dealt with following questions: Has medical progress (i.e. MRI, comprehensive information) led to better results? Does predictors exists which patients will have a benefit?

Methods: Retrospective analysis of 15 patients (13 male; mean age of 65 years, range 53-77) between 2002 and 2004 (3 years) which undergone acute (defined as a time-intervall between introduction and operation of less than 24 hours) decompressive laminectomy in metastatic spinal disease with a progredient neurological deficit regarding pre- and postoperative Nurick grade, duration of preoperative paresis, histology, age and comorbidity.

Results: From 15 patients only 3 patients (20%) improved regarding paresis respectively Nurick grade in the postoperative follow-up for 3 weeks. These 3 patients had a duration of preoperative paresis of less or equal of 24 hours. A duration of more than 24 hours correlated with no post- operative improvement regarding paresis and ambulatory outcome. No patient deteriorated after acute decompressive laminectomy. 1 patient had a postoperative epidural bleeding without deterioration in paresis but revision. Age, histology and comorbidity had no influence on postoperative paresis and ambulatory outcome. Lung (53%) and prostate cancer (13%) dominated in histology.

Conclusions: Acute decompressive laminectomy in spinal epidural metastases was, is and remains an emergency operation from which only a few and selected patients have a benefit. Medical progress had not led to better results. The duration of preoperative paresis is a predictor for postoperative outcome.