Surgical treatment of metastatic lesion of the spine. A review of 51 consecutive cases operated

Abstract Metastatic lesions of the spine have recently become a debated topic in orthopaedics, because more and more patients survive long enough to require surgical treatment. The aim of this study is to review a series of 51 patients affected by metastatic lesions of the spine. Fifty-one patients affected by metastatic lesions of the spine were treated between 1987 and 2000. In 5 cases the cervical spine was involved, in 27 the thoracic and in 19 the lumbar spine. Surgery was planned according to the following labelling factors: type of malignancy, life expectancy, neurological involvement, pain, site of lesion, lesion extension and spine stability. Surgical treatment consisted of: minimally invasive cord decompression in 3 cases, posterior stabilization in 21, posterior stabilization and cord decompression in 13 cases, anterior resection and reconstruction of anterior column associated or not at posterior stabilization in 14 cases. Two patients died due to complications related to surgery. At the last available follow-up of 4 (±2.5) years, 29 patients had excellent results, 16 had good results, 2 fair and 2 poor results. One fair and 1 poor result had recurrence of the metastatic lesions of the spine and needed another operation. We believe that surgical treatment of metastatic lesion of the spine has a positive cost/benefit ratio for the patient's condition; in fact most of our patients had improvement of quality of life. The labelling factors of each lesion have to be carefully studied together with the oncologist to decide the correct surgical option because unsatisfactory results could be sometimes related to incorrect evaluation of the evolution of the neoplasm.