RESUMO
A retrospective assessment of the decompression-stabilization procedures for malignant spinal lesions was done. Twenty-six patients underwent decompression-stabilization procedures for metastatic spinal lesions. The patients were classified according to their malignant lesion involvement of the three columns of the spine. One column was involved in only one case, two columns were involved in eleven cases and three columns were involved in fourteen cases. A posterior approach alone was done in eight patients, while combined anterior- posterior approach was done in eighteen cases. A variety of posterior stabilization procedures was used. The results obtained from direct anterior approaches using vertebrectomy and anterior reconstruction of the anterior and middle columns produced the best results in terms of neurological improvement. Almost all of the patients had two or three columns involvement, but the results did not support the three columns theory, where the significant results regarding the pre- or postoperative radiographic measurements [mechanical instability] and pre- or postoperative neurologic findings [neurologic instability] could not be correlated with the number of the involved columns