Skip to main content
SpringerLink
Log in

Utility of surgery in the treatment of epidural vertebral metastases

  • Clinical Articles
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

Treatment of vertebral epidural metastases has been in the past and still remains the object of special attention in an attempt to improve the quality of life of these patients. To assess the effects of and indications for surgery, the clinical histories of 53 patients with this malignant disease who had undergone decompressive laminectomy have been reviewed retrospectively. The importance of the presence of complete or partial spinal cord compression in correlation with the presence of complete or partial myelographic block is dealt with. The results concerning pain, gait disturbances and sphincter disorders are studied with respect to the clinical and myelographic picture for the purpose of establishing the indications for decompressive laminectomy. Pain is not an indication for operative decompression, and complete paraplegia always never improves, thus being a contraindication. But in incomplete spinal cord involvement a decompression operation may be followed by an improvement of neurological deficit and quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Abrams ML (1950) Skelet al metastases in carcinoma. Radiology 55: 534–538

    PubMed  Google Scholar 

  2. Alexander JR, Davis CM, Frield CM (1956) Metastatic lesions of the vertebral column causing cord compression. Neurology (Minneap) 6: 103–107

    Google Scholar 

  3. Arseni CV, Simionescu MD, Horwath L (1959) Tumours of the spine. A follow-up study of 350 patients with neurosurgical considerations. Acta Psychiat Scand 34: 398–410

    PubMed  Google Scholar 

  4. Auld AW, Buerman B (1966) Metastatic spinal epidural tumours. Arch Neurol 15: 100–108

    PubMed  Google Scholar 

  5. Barron KD, Mirano A, Araki S, Terry RD (1959) Experience with metastatic neoplasias involving the spinal cord. Neurology 9: 91–106

    PubMed  Google Scholar 

  6. Basauri L, Maldonado E (1970) Neoformaciones raquimedulares cervicales. Neurocirugía 28: 62–71

    Google Scholar 

  7. Bernat JL, Greenberger MS, Barret J (1983) Suspected epidural compression of the spinal cord and cauda equina by metastatic carcinoma: clinical diagnosis and survival. Chancer 51: 1953–1957

    Google Scholar 

  8. Bope ET (1987) Follow-up of the cancer patients: surveillance for metastases. Prime Care J 14: 391–401

    Google Scholar 

  9. Brady LW, Antoniades J, Prasavinidrais Set al (1975) The treatment of metastatic disease of the nervous system by radiation therapy. In: Seydel HG (eds) Tumours of the nervous system. J Wiley and Sons, New York, pp 176–188

    Google Scholar 

  10. Brice J, McKissock W (1905) Surgical treatment of malignant extradural spinal tumours. Br Med J 1: 1341–1344

    Google Scholar 

  11. Brihaye J, Smets W, Rood M (1959) Le traitment chirurgique des paraplegies cancereures. Acta Chir Belg 58: 794–810

    PubMed  Google Scholar 

  12. Bucy DC (1963) The treatment of malignant tumours of the spine: a review. Neurology 13: 938–944

    PubMed  Google Scholar 

  13. Chade H-O (1975) Metastatic tumours of the spine and spinal cord. In: Vinken DJ, Bruyn GW (eds) Handbook of clinical neurology, Vol 18. North-Holland Publishing Company, Oxford, pp 435–481

    Google Scholar 

  14. Charcot JM (1880) Leçons sur les maladies du systéme nervaux. Masson, Paris, p 88

    Google Scholar 

  15. Cobb CA, Leavens ME, Eckless N (1977) Indications for nonoperative treatment of spinal cord compression due to breast cancer. J Neurosurg 47: 653–658

    PubMed  Google Scholar 

  16. Cohen DH, Dahlin DC, McCarty CS (1964) Tumeurs apparenment solitaires de la colonne vertébrale. Mayo Clin Proc 39: 509–528

    PubMed  Google Scholar 

  17. Constans JP, De Divitis E, Donzelli Ret al (1983) Spinal metastases with neurological manifestations: review of 600 cases. J Neurosurg 59: 111–118

    PubMed  Google Scholar 

  18. Dining F (1961) Malignant spinal extradural tumours. Aust N Z J Surg 31: 126–133

    PubMed  Google Scholar 

  19. Dunn RC, Kelly WA, Whomet al (1980) Spinal epidural neoplasia. A 15-year review of the results of surgical therapy. J Neurosurg 52: 47–51

    PubMed  Google Scholar 

  20. Elsberg CA (1928) Extradural spinal tumours: primary, secondary, metastatic. Surg Gynec Obstet 46: 1–20

    Google Scholar 

  21. Epstein BS (1973) Afecciones de la columna vertebral y de la médula espinal. Estudio Radiológico y clínico. In: Jano, pp 397–462

  22. Feiring EH, Hubbard JM (1965) Spinal cord compression resulting from intradural carcinoma. Report of two cases. J Neurosurg 23: 635

    PubMed  Google Scholar 

  23. Fradies A, Verma J (1964) An explanation of certain disturbances in root and spinal cord compression. Psychiat et Neurol, pp 69–83

  24. Greenberg MS, Kim J, Posner JB (1980) Epidural spinal cord compression from metastatic tumor: results with a new treatment protocol. Ann Neurol 8: 361–366

    PubMed  Google Scholar 

  25. Karanas A, Silver RT (1968) Characteristics of the terminal phase of chronic granulocyte leukemia. Blood 32: 445

    PubMed  Google Scholar 

  26. Kennady JC, Stern WE (1962) Metastatic neoplasms of the vertebral column producing compression of the spinal cord. Am J Surg 104–155

  27. Langley GR, Sabean MB (1966) Sclerotic lesions of bone in myeloma. Can M A J 94: 940

    Google Scholar 

  28. Leavens ME, Stratton C, Cech DA, Weyland JB, Weston JS (1982) Intrathecal and intraventricular morphine for pain in the cancer patients: initial study. J Neurosurg 56: 241–245

    PubMed  Google Scholar 

  29. Livingston KE, Perm RG (1981) Treatment of spinal metastasis (Letters to the Editor). J Neurosurg 54: 710–711

    PubMed  Google Scholar 

  30. Paillas JE, Alliez B, Pellet W (1976) Primary and secondary tumours of the spine. In: Vinken DJ, Bruyn GW (eds) Handbook of clinical neurology, Vol 18. North-Holland Publishing Company, Oxford, pp 19–55

    Google Scholar 

  31. Portenoy RK, Lipton RB, Foley KM (1987) Back pain in the cancer patient; an algorithm for evaluation and management. Neurology 37: 134–138

    PubMed  Google Scholar 

  32. Rasmussen TB, Kernohan JB, Wadson A (1940) Pathologic classification with surgical consideration of intraspinal tumours. Ann Surg 111: 513–530

    Google Scholar 

  33. Shapiro WR, Posner JB (1983) Medical versus surgical treatment of metastatic spinal cord tumors. In: Thompson RA, Green JR (eds) Controversies in neurology. Raven Press, New York, pp 57–65

    Google Scholar 

  34. Shenkin HA, Horn RC, Grant FC (1945) Lesions of the spinal epidural space producing cord compression. Arch Surg 51: 125–146

    Google Scholar 

  35. Smith R (1965) An evaluation of surgical treatment for spinal cord compression due to metastatic carcinoma. J Neurol Neurosurg Psychiatry 20: 152

    Google Scholar 

  36. Törma T (1957) Malignant tumours of the spina and the spinal extradural space. A study based on 250 histologically verified cases. Acta Chir Scand 225 [Suppl]: 1–138

    Google Scholar 

  37. Ushio Y, Posner R, Kim JMet al (1977) Experimental spinal cord compression by epidural neoplasms: treatment. J Neurosurg 47: 380–390

    PubMed  Google Scholar 

  38. Vieth RG, Odom Gl (1965) Extradural spinal metastases and their neurosurgical treatment. J Neurosurg 23: 501–508

    PubMed  Google Scholar 

  39. Wolfson SA, Rezaick S, Sauther L (1941) Early diagnosis of malignant metastases to the spine. A clinical syndrome. J AM Med Asso 116: 1044–1048

    Google Scholar 

  40. Wright LR (1963) Malignant tumours in the spinal extradural space. Results of surgical treatment. Ann Surg 157: 227–231

    PubMed  Google Scholar 

  41. Young RF, Post GM, King GA (1980) Treatment of spinal epidural metastases. J Neurosurg 53: 741–748

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department for Neurosurgery, Hospital de la Príncesa, Madrid, Spain

    A. García-Picazo, P. Capilla Ramírez, P. Pulido Rivas & R. Garcia de Sola

Authors
  1. A. García-Picazo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Capilla Ramírez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Pulido Rivas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. Garcia de Sola
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

García-Picazo, A., Ramírez, P.C., Rivas, P.P. et al. Utility of surgery in the treatment of epidural vertebral metastases. Acta neurochir 103, 131–138 (1990). https://doi.org/10.1007/BF01407520

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01407520

Keywords

Search

Navigation