Surgical treatment of cervical spine metastatic tumours - case report

Background. Metastatic tumours to the cervical spine generate pathological fractures followed by spinal instability and are connected with significant risk of neurological defects.
The goal of this study was to asses the surgical treatment of 4 patients with metastatic tumours in the cervical spine.
Material and methods. Between 1999 and 2001 four patients underwent surgery due to metastatic tumours in cervical spine. Primary focus was following: breast - 2 patients, prostate - 1 patient, in one case primary tumor remained unknown. Spinal localization of tumors: axial dens, vertebral body and arch of C5, vertebral body of C6. Patients' age at the time of surgery ranged from 48 to 75 years. The severity of spinal cord lesion before treatment was estimated according to Frankel classification: type B - 1 patient, E - 3 patients. According to Harrington classification, we noted type IV in 3 cases and type V - in one case.
Tumour resection with anterior and posterior stabilization, with use of implants was performed at 2 cases, occipito-cervical stabilization was done at one case and tumor resection with anterior stabilization was done in one case.
Results. Patients' neurological status did not change after treatment. As a result of operative treatment, we achieved full spine stabilization in 3 cases. Destabilization of vertebral cage due to osteoporosis occurred in one case and reoperation with change of the implant was performed at the fifth day after primary surgery.
Conclusion. Performed operations enabled further specialistic oncologic and rehabilitation treatment.