ABSTRACT
<p><b>OBJECTIVE</b>To explore the relationship of motor dysfunction of the lower extremities with the imaging appearances and clinical features of metastatic epidural spinal cord compression (MESCCs).</p><p><b>METHODS</b>From July 2006 to December 2007, 26 successive patients with metastases of the thoracic, lumbar and the cervical spine were treated in our department. Forty-three main involved vertebra in all 26 patients were evaluated by magnetic resonance imaging and computed tomography, and were scored according motor dysfunction in this study. Fourteen patients (25 vertebrae) had motor dysfunction.</p><p><b>RESULTS</b>Among 26 patients, 12 cases with visceral metastasis,in which had motor dysfunction in 10 cases; 14 cases without visceral metastasis, in which had motor dysfunction in 4 cases; comparison between two groups, P=0.0079. Among vertebral presence of continuity of 43 main involved vertebrae, 16 vertebrae had motor dysfunction;among vertebral absence of continuity, motor dysfunction occurred in 9 vertebrae, comparison between two groups, P=0.1034. Among vertebral presence of lamina involvement of 43 main involved vertebrae, 11 vertebrae had motor dysfunction; among vertebral absence of lamina involvement, motor dysfunction occurred in 14 vertebrae, comparison between two groups, P=0.020 5. Among vertebral presence of protruding of vertebral posterior wall of 43 main involved vertebrae, 12 vertebrae had motor dysfunction; among vertebral absence of protruding of vertebral posterior wall, 13 vertebrae had motor dysfunction, comparison between two groups, P=0.0334. Among vertebral presence of involvement epidural space of 43 main involved vertebrae, 11 vertebrae had motor dysfunction; among vertebral absence of involvement epidural space, 14 vertebrae had motor dysfunction, comparison between two groups, P=0.003 6. Such factors as age, gender, whether or not received regular chem before admission, back pain degree of metastasis, received regular chem before admission, therapeutic efficacy of primary tumor, number of bony metastases outside spine, number of the main involved vertebrae, level of vertebral metastases location, level of continuous involved vertebrae, vertebral-body involvement, fracture of anterior column, fracture of posterior wall, and pedicle involvement had no effects on incidence of motor dysfunction due to MESCC (P>0.05).</p><p><b>CONCLUSION</b>MESCC with visceral metastases, lamina involvement, presence of outstanding buttocks sign of posterior wall,involvement epidural space tended to cause symptomatic MESCC. Incidence of continuity of main involved vertebrae occurred more frequently in the CUTS compared with other levels of spine.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Movement Disorders , Radiography , Spinal Cord Compression , Diagnostic Imaging , Spinal NeoplasmsABSTRACT
Background and purpose:It is difficult to diagnose gastric cancer at an early stage,thus the resectable probability of gastric cancer is low.This study was to explore the efficacy of neoajuvant chemotherapy in terms of resectablity for the patients with advanced gastric cancer.Methods:Eighty-six patients with advanced gastric cancer were randomly divided into routine surgical operation group and neoajuvant chemotherapy+surgical operation group.The patients were examined by CT before surgery.The patients in neoajuvant chemotherapy+surgical operation group received two cycles of neoajuvant chemotherapy,and then were evaluated by CT.Results:In routine surgical operation group,the overall resectability rate was 83.7%(36/43),and the curative resection rate was 46.5%(20/43), 16.3%(7/43)was done by exp.lap.In neoajuvant chemotherapy+surgical operation group,the overall resectability rate was 93.0%(40/43),and the curative resection rate was 69.8%(30/43),only 7.0%(3/43)was exp.lap.No mortality was observed.There were no significant difference between both groups in terms of toxicities.Conclusions:The overall resectability rate and the curative resection rate are increased in patients with advanced gastric cancer aider neoajuvant chemotherapy.