P07.05 * THE ROLE OF SURGERY IN PALLIATIVE TREATMENT OF METASTASES INVOLVING THE CERVICAL SPINE. OUR EXPERIENCE AND REVIEW OF THE LITERATURE

Abstract

INTRODUCTION: Spinal column is the most common site of skeletal metastases. Cervical spine involvement may occur in 10% of cases. In cervical spine metastases the surgery may have an important role in multidisciplinary palliative treatment. Pain control, neurological improvement, the restoration of cervical spine stability and the very soon mobilization were effective in improving quality of life of these patients with minimally invasive surgical technique. CASE REPORTS: CASE 1) A 68 year-old man with an history of prostate cancer was admitted to our observation with intractable cervical pain. Cervical CT scan and MRI revealed a lesion involving C2. Surgical treatment: biopsy and vertebroplasty of C2 (transoral approach). The post-operative course was uneventful; neck pain relief was reported. Pathological examination was: metastases from prostate cancer. CASE 2) A 51 year-old man with an history of lung cancer was admitted to our observation with radicular pain of the right arm. Cervical CT scan and MRI revealed a vertebral body destruction of C4. Surgical treatment: complete C4 anterior corpectomy and fusion (Ulrich ADD-plus). Uneventful procedure; pain relief was reported. Pathological examination was: metastases from lung cancer. CASE 3) A 49 year-old woman with an history of breast cancer was admitted to our observation with cervical radiculopathy. Cervical CT scan and MRI revealed a vertebral body destruction of C7. Surgical treatment: complete C7 anterior corpectomy and fusion (Ulrich ADD-plus). Uneventful procedure; pain relief was reported. Pathological examination was: metastases from breast cancer. CONCLUSIONS: Minimally invasive surgery may be considered in multidisciplinary palliative treatment. In our cases the surgery has really improved the quality of life of the patients (relief of pain, stabilization of cervical spine). A review of the literature confirmed that in selected cases surgical treatment of cervical metastases is feasible and associated to low rate of morbility.