gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Surprising results in the treatment of secondary spine tumour surgery

Chirurgische Therapie sekundärer spinaler Tumore: Überraschende Ergebnisse

Meeting Abstract

Suche in Medline nach

  • corresponding author S. Erülkü - Neurochirurgische Klinik der Universitätskliniken des Saarlandes, Homburg
  • T. Pitzen - Neurochirurgische Klinik der Universitätskliniken des Saarlandes, Homburg
  • W. I. Steudel - Neurochirurgische Klinik der Universitätskliniken des Saarlandes, Homburg

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSO.02.10

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Veröffentlicht: 11. April 2007

© 2007 Erülkü et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Objective: Treatment of secondary spinal tumours is a challenging problem in spine surgery from at least two aspects: First: Surgery due to spine tumours may be technically demanding. Next, we must consider which patient may profit from which kind of surgery. The objective of our study was to investigate 1. neurological outcome, 2. survival time, 3. complication rate in our patient population between 01/ 2004 and 07/ 2006.

Methods: This is a retrospective study on 40 patients suffering from either metastatic disease in at least one vertebra or manifestation of a lymphoma in the spine. They were all operated by one single surgeon. A score according to Tokuhashi was used to predict life expectancy. Using this score value as a predictor, surgical treatment was performed as extensive decompression and sufficient fixation (short time survivors), or en bloc spondylectomy (long time survivors).

Results: 21 male, 19 female patients were included. Mean age at the time of diagnosis was 63 yrs. The primary tumour site was the lung (20%), the prostate (20%) and the breast (8%). We saw spinal manifestation of a lymphoma in another 20 %. Due to wide spread tumour disease, predicting limited life expectancy, partial tumour removal and stabilization was the surgical strategy in 95%. In only 2 patients (5%) was radical tumour excision possible. Neurological outcome was improved in 20%, unchanged in 70%, worse in 10% of our patient sample. We found the Tokuhashi's score to be useful for predicting life expectancy. There was a strong correlation between this score and patients' survival time (R2=0.4848). 5% of the patients died within the first 5 months after surgery. Complications were seen in 25% of the patients including a postoperative mortality of 10%.

Conclusions: In most of the patients (70%), signs of spinal compression will not be changed. 35% of the patients die within 5 months after surgery. Life expectancy may be predicted by scoring these patients according to Tokuhashi's suggestions. Surgery of metastases or lymphomas of the spine has a very high complication rate (25%), including a mortality rate of 10%. These are important and somewhat surprising results. Facing these facts, proper patient selection for spinal surgery seems to be the most important step in treatment.