Diagnosis Of Spinal Metastasis Research Articles

Malignant Intracranial Meningioma With Spinal Metastasis -Case Report-

A 48-year-old woman presented with a left cerebellopontine angle mass. Over a 93-month period, the patient underwent seven surgeries, two radiosurgeries, and one external beam radiotherapy. The tumor was histologically benign at the first operation, but exhibited unusually aggressive behavior after failed radiosurgery and demonstrated clinical characteristics of malignancy such as spinal metastasis. The patient underwent gamma knife radiosurgery (GKR) for recurrence after the first operation, despite the tumor being located in a resectable region. The tumor did not respond. Six months after the sixth surgery, the patient presented with progressive lower extremity paraparesis and sensory disturbance below the T11 dermatome. Magnetic resonance imaging revealed multiple intradural mass lesions located at the T2, T11-T12, and L2 levels. She died 4 months after the diagnosis of spinal metastases. Retrospectively, we speculate that if a tumor is located in a resectable region and Simpson grade I or II tumor resection is possible, direct surgery may be a safer option than GKR.

A comparative study of different imaging method for diagnosis of spinal metastasis

Objective To analyze and compare the findings,sensitivity and specificity of conventional single photo emission computer tomorgraphy(SPECT) and magnetic resonance imaging (MRI),in the diagnosis of spinal metastasis.Methods 60 cases of spinal metastasis which were proved by clinical pathology were analyzed ,and compared with the findings on ECT and MRI.Results 60 cases of spinal metastases were found in 200 vertebral anomalies,the sensitivity of ECT and MRI were 93.0%(186/200)and 96.6%(193/200) in spinal metastases;specificity were 54.8%(102/186) and 94.8%(183/193).Conclusion MRI is of high sensitivity and specificity in the diagnosis of spinal metastasis,ECT for spinal metastases has a certain value. Key words: Spinal neoplasms; Neoplasm metastasis; Tomorgraphy,emission-computed,single-photon; Magnetic resonance imaging

Complication, survival rates, and risk factors of surgery for metastatic disease of the spine.

The risk factors for complications and complication and survival rates in patients with metastatic disease of the spine were reviewed. A retrospective study was performed. To determine the surgical complication and survival rates of patients with metastatic disease of the spine and risk factors for complication occurrence. The role of surgical intervention for patients with metastatic disease of the spine has been controversial. Several risk factors for surgical complications have been identified. Short survival times and high complication rates have failed to justify surgical intervention in many cases. Patients (n = 80) undergoing surgical treatment for metastatic disease of the spine were reviewed. Surgical indications included progressive neurologic deficit, neurologic deficit failing to respond to, or progressing after, radiation treatment; intractable pain; radioresistant tumors; or the need for histologic diagnosis. Patients underwent anterior, posterior, or combined decompression and stabilization procedures. Neurologic examination was recorded before surgery, postoperative period, and at least follow-up. Complication and survival rates were calculated. Several variables were examined for risk of complication. The mean age at time of surgery was 55.6 years (range, 20-84 years). Mean survival time after the diagnosis of spinal metastasis was 26.0 months (range, 1-107.25 months). Mean survival time after surgery was 15.9 months (range, 0.25-55.5 months). Sixty-five patients showed no change in Frankel grade, 19 improved one Frankel grade, and 1 deteriorated one Frankel grade; 1 patient had paraplegia. Thirty-five complications occurred in 20 patients (25.0%). Ten patients (12.5%) had multiple complications accounting for 23 of the 35 postoperative problems (65.7%). Sixty patients had no surgical complications (75%). There were no intraoperative deaths. The likelihood that a complication occurred was significantly related to Harrington classifications demonstrating significant neurologic deficits and the use of preoperative radiation therapy. In general, Harrington classifications with neurologic deficits and lower Frankel grades before and after surgery were associated with an increased risk of complication. Overall, the major complication rate was relatively low, and minor complications were successfully treated with minimal morbidity. The relatively long survival time after spinal surgery in this group of patients justifies surgical treatment for metastatic disease. Most complications occurred in a small percentage of patients. To minimize complications, patients must be carefully selected based on expected length of survival, the use of radiation therapy, presence of neurologic deficit, and impending spinal instability or collapse caused by bone destruction.

Diagnosis and management of spinal metastases from breast cancer

Metastases to the spine is a common manifestation of breast cancer leading to considerable reduction in the patient's quality of life due to troublesome back pain and neurologic morbidity. It is not uncommon for spinal metastases to be an early and predominant manifestation of the patients systemic disease process. Although the breast cancer must be considered to be advanced, these patients will frequently have a reasonable functional status at the time of diagnosis of the spinal metastases. Accordingly, an aggressive approach of management should be considered in such patients so as to potentially achieve the most effective palliation. In the setting of breast cancer metastatic to the spine, radiation/systemic steroidal therapy remains the first line of management. The principle exception favoring primary surgical management is roentgenographic evidence of spinal instability related to the vertebral involvement by the metastatic process. The surgical team must also remain ready to intervene early with surgical decompression and spinal stabilization when any neurologic deterioration occurs during radiation therapy. When surgery is indicated, the anterior transthoracic approach to spinal metastases is an effective means of palliating these breast cancer patients.

Early Diagnosis of Spinal Metastases by CT and MR Studies

Early Diagnosis of Spinal Metastases by CT and MR Studies