Vol 32| Issue 1 | Jan – June 2019 | page: 23-26 | Suresh S. Pillai, Ali Sabith, Jim Thomas Malayil
Authors: Suresh S. Pillai [¹], Ali Sabith [¹], Jim Thomas Malayil [¹]
 Baby Memorial Hospital, Calicut, Kerala, India.
Address of Correspondence
Dr. Suresh S. Pillai,
Consultant Spine Surgeon,
Baby Memorial Hospital Calicut, Kerala, India
Spine is the most frequent site of spinal metastasis after liver and lung due to its extensive arterial supply. The cancer tissue replaces the spinal elements leading to its destruction and resultant instability and compression of the neural structures 4. 10% of tumor patients develop asymptomatic spinal metastasis and spinal cord compression(5,6). The purpose of treating patients with spinal metastasis are to relieve pain, stabilizing spinal structures , recovering or maintain neural function, controlling the metastasis in the local area and improving quality of life. This goal is achieved through a multidisciplinary approach. The aim of this article is to describe an algorithm for the management of solitary spinal metastasis. Different factors need consideration in planning treatment for solitary metastasis. Age, quality of life, tumor borders etc should be discussed in detail with the patient and his/her care givers. A multidisciplinary approach and a tumor board meeting would bring out the right choice for a given patient. Treatment may vary from irradiation, biopsy/surgery, chemotherapy, immuno-modulation, hormone therapy or palliative treatment alone
Keywords: Metastasis Spine, Solitary, Algorithm
1. Krishnaney AA, Steinmetz MP, Benzel EC., Biomechanics of metastatic spine cancer. Neurosurg Clin NAm 2004;15(4):375- 80
2. Hosono N , Yonenobu K , Fuji T , Ebara S , Yamashita K , Ono K Orthopedic management of spinal metastasis, Clin Orthop Relat Res 1995(312):148-159
3. Zhantao Deng, Bin Xu, Jiewen Jin, Jianning Zhao, Haidong Xu, Stratergies for management of spinal metastasis, a comprehensive review
4. Gasbarrini A, Cappuccio M, Mirabile L, Bandiera S, Terzi S, Barbanti Brodano G, Boriani S. Spinal metastases: treatment evaluation algorithm. Eur Rev Med Pharmacol Sci 2004; 8(6): 265-74.
5. Harrington KD, Orthopedic Surgical Management of Skeletal Complications of Malignancy, Cancer. 1997 15;80(8
6. F. Bach, B. H. Larsen, K. Rohde, S. E. Børgesen, F. Gjerris, T. Bøge- Rasmussen, N. Agerlin, B. Rasmusson, P. Stjernholm, P. S. Sørensen. Metastatic spinal c o r d c o m p r e s s i o n , occurrence, symptoms, clinical presentations and prognosis in 398 patients with spinal cord compression. Acta Neurochirurgica 1990, 107, 1–2, pp 37–43
7. Lenz M, Freid JR. Metastases to the skeleton, brain and spinal cord from cancer of the breast and the effect of radiotherapy. Ann Surg. 1931;93(1):278-93.
8. Sundaresan N, Krol G, Digiacinto GV, et al: Metastatic tumors of the spine, in Sundaresan N, Schmidek HH, Schiller AL, et al (eds): Tumors of the Spine, diagnosis and clinical management pp 279-304. Philadelphia, WB Saunders, 1990.
9. Daniel M.Sciubba MD, TrangNguyen BS, Ziya L.Gokaslan MD, solitary vertebral metastasis, Orthop Clin N Am 40(2009)145- 154
10. Constans JP, Divitiis ED, Donzelli R, et al: Spinal metastases with neurological manifestations: Review of 600 cases. J Neurosurg 59:111-118, 1983.
11. Gabriel K, Schiff D. Metastatic spinal cord compression by solid tumors. Semin Neurol. 2004 24(4):375-83.
12. Schiff D, spinal cord compression. Neurol Clin 2003; 21 (1) 67- 86
13. Van der Sande JJ, Boogerd W, Kröger R et al, recurrent spinal epidural metastases: a prospective study with a complete follow up. J Neurol Neurosurg Psychiatry. 1999 May;66(5):623-7.
14. Sundaresan N1, Rothman A, Manhart K et al, Surgery for solitary metastases of the spine: rationale and results of treatment, spine 2002, 27(16), 1802-6
15. Batson OV: The function of vertebral veins and their role in the spread of metastases. Ann Surg 112:138-149, 1940
16. Ross J, Brant Zawadzki M, Moore JR et al, neoplasms, cysts, and other masses In Ross J editor
17. Choong PF, The molecular basis of skeletal metastases, Clin Orthop Relat Res. 2003;(415 Suppl):S19-31.
18. Yuh WT1, Quets JP, Lee HJ et al, Anatomic distribution of metastases in the vertebral body and modes of hematogenous spread, Spine 1996;21(19):2243-50
19. Bach F, Larsen BH, Rohde K, et al: Metastatic spinal cord compression: Occurrence, symptoms, clinical presentations, and prognosis in 398 patients with spinal cord compression. Acta Neurochir (Wien) 107:37-43, 1990.
20. Botterell EH, Fitzgerald GW, Spinal cord compression produced by extradural malignant tumors; early recognition, treatment and results, Can Med Assoc J. 1959; 80(10):791-6.
|How to Cite this Article:Pillai S S, Sabith A, Malayil J T. Algorithm for Management of Solitary Spinal Metastases. Kerala Journal of Orthopaedics Jan-June 2019; 32(1): 23-26 .|