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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Surgical treatment for metastatic disease of the cervicothoracic junction (C6-D2) – A single center experience

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  • Andreas Baumann - Neurochirurgie, Klinikum Köln Merheim, Universität Witten Herdecke, Köln, Deutschland
  • Alhadi Igressa - Neurochirurgie, Klinikum Köln Merheim, Universität Witten Herdecke, Köln, Deutschland
  • Resul Bulmus - Neurochirurgie, Klinikum Köln Merheim, Universität Witten Herdecke, Köln, Deutschland
  • Makoto Nakamura - Kliniken der Stadt Köln, Klinikum Merheim, Neurochirurgische Klinik, Köln, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocP 098

doi: 10.3205/17dgnc661, urn:nbn:de:0183-17dgnc6617

Published: June 9, 2017

© 2017 Baumann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: The skeleton is the third most common site of metastatic disease. Spinal metastases are apparent in approximately 70% of these cases. As a transition zone between thoracic and cervical spine, the cervicothoracic junction (CTJ) is of special relevance regarding surgical strategy in case of symptomatic tumorous disease.

Methods: We have performed a retrospective analysis including 54 patients who have undergone surgical treatment for metastatic disease of the CTJ in our institution over a period of seven and a half years (August, 1st, 2008 until December 31st, 2015). We have performed survival analysis using the Kaplan-Meier method and tried to identify independent risk factors via nonparametric statistics and the Cox's proportional hazards model.

Results: The mean age of our cohort at the time of surgery has been 64.2 +/- 10.4 years, with a clear male predominance (41=76%). Bronchial carcinoma has been the most prevalent entity (n=17), followed by prostate (n=10) and mammary carcinoma (n=7). The overall mean survival after surgery has been 1.32 +/- 0.28 years, with the lowest survival for patients with bronchial carcinoma. Patients who have undergone surgical stabilization (36=66,7%) showed a higher survival time. A low Tokuhashi score and neurological deficit at the time of surgery turned out to predict reduced survival in the first analysis.

Conclusion: The selection of surgical strategy is crucial, depending on live expectancy and spinal instability. The revised Tokuhashi score is a good tool to guide through the surgical decision making for metastases of the CTJ, which is needed in presence of new neurological deficit.