Metastatic/Myeloma Disease—Operative Management

The spine is the most common site of skeletal or osseus metastases. Rates of spinal metastases can vary widely according to the primary tumor. The growing number of patients with metastatic processes in the spine requires application of sound oncological principles to reduce the morbidity and mortal...

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Bibliographic Details
Published inEvidence‐Based Orthopedics pp. 721 - 727
Main Authors Malempati, Harsha, Qamirani, Erion, Yee, Albert J. M
Format Book Chapter
LanguageEnglish
Published Oxford, UK Wiley‐Blackwell 09.12.2011
Subjects
corticosteroids
en bloc tumor resection
kyphoplasty
radiotherapy
Spine metastasis
surgical decompression
vertebroplasty
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Summary:The spine is the most common site of skeletal or osseus metastases. Rates of spinal metastases can vary widely according to the primary tumor. The growing number of patients with metastatic processes in the spine requires application of sound oncological principles to reduce the morbidity and mortality associated with interventions. Our literature review has addressed some of the important questions with respect to the operative management of metastatic disease of the spine. Balloon kyphoplasty and vertebroplasty play an important role in the management of pathological fractures and painful spinal metastases that are resistant to medical management. Corticosteroids have a limited role in patients with metastatic epidural spinal cord compression (MESCC), and their use is associated with a high rate of adverse effects. Surgical decompression with adjuvant radiotherapy should be considered as the primary treatment option for patients with MESCC,. There is very little evidence to support the use of en bloc spondylectomy as a treatment option for solitary spinal metastases.
ISBN:9781405184762
1405184760
DOI:10.1002/9781444345100.ch84