Clinical Analysis of 27 Cases of Metastatic Spine Tumors

ABSTRACT

The authors analyzed 27 cases of metastatic spine tumors who had been treated at the Department of Neurosurgery of Catholic University Medical College during last 5 years. The results were summarized as follows 1) The tumor was most common in 6th decade of age(40.7%), and the male to female ratio was equal. 2) The level of the involved spine was thoracic(51.9%), lumbosacral(25.9%), cervical(22.2%) in orders. 3) The most common histopathologic type of the primary focus was lung cancer(25.9%), and nexts were gastric cancer, cervix cancer, breast cancer in frequency. 33.3% of all cases were histologically undetermined. The level of the involved spine was not related to the primary cancer type. 4) The common clinical features were pain(70.4%), motor disturbance(33.3%), sensory disturbance(25.9%) and sphincter symptom(11.1%). In plain X-ray examination, pedicle destruction was most commonly found(40.7%), and all 4 cases of bone scanning showed multiple hot area. In myelography, extradural complete block of dye co lumn was found in 9 cases(60%), and a case showed finding of intradural-extramedullary block. Computerized tomography with water soluble contrast media, which can give a most accurate diagnostic information, showed destruction of the vertebral body(61.5%), pedicle(39.5%) and shadows of tumor compressing the spinal cord(38.5%). 5) 4 cases were receivd surgical treatment only and 8 cases were treated with radiation therapy. Surgery with radiation therapy was performed in 8 cases and 7 cases were treated with radiation therapy and chemotherapy. The results of treatment in 19 survivals were analyzed according to the neurologic function between before and after treatment. 8 cases(42.1%) were improved and 7 cases(36.8%) showed no change, and 4 cases(21.1%) were more worsened comparing to pre-treatment state.