The results of surgical treatment of secondary lesions of the spine

Boychuk S.I.1, Diedkov A.G.1, Samonenko Y.M.2, Volkov I.B.1, Maksimenko B.V.1, Vasiljev O.V.1, Dorogynskyi V.I.1

Summary. Introduction. Vertebral metastases in patients with cancer occur approximately in 30–40% of all cases. In the structure of tumor pathology of the spine, metastatic lesion up to 96% mainly localized in the thoracic spine because of tohematogenous spreading of metastasis of most malignant tumors. Aim. To improve the quality of life of patients with vertebral metastatic lesions by reduction of the intensity of pain syndrome, reduction of non-backward neurological symptoms like paralysis, plegias, renewal of the limb’s functions of the films as a result of surgical treatment. Materials and methods. The surgery was provided to 15 males (55.6%) and 12 (44.4%) female with metastatic vertebral lesions. Mean age was 48.9±2.4 years. All the patients underwent full physical examination before surgical treatment, including assessments to evaluate bone and visceral dіssemination, Visual Analogue Scale pain, quality of life according to Karnofski scale, neurologic status according Frankel scale, Tokuhashi life prognostic scale. Results. The assessment of the results of surgical treatment was carried out according to orthopedic and oncological criterias. After provided surgery the improvement of neurologic status observed in19 (70.37%) of patients; the neurologic symptoms remain stable in 3 (11.2%) of patients, worsening of neurological status — in 5 (18.51%) of patients. Life quality improved in 17 (62.96%), remain stable in 7 (25.92%) and worsening in 3 (11.2%) of patients. The average survival of patients with metastatic renal cell carcinoma was 8.1 ± 1.64 months. The result of comparing of actual and projected survival rates according to the Tokuhashi scale demonstrated that the expected 1-year survival rate was 21% and the actual survival rate was 27%. In patients with bone metastasis of prostate cancer the average life expectancy was 15.2 ± 3.2 months. According to the Tokuhashi prognostic scale the expected 1-year survival rate was 42% and the actual survival rate was 67%. Conclusions. The results show a benefits of palliative surgical treatment of secondary bone lesions of the spine in patients that significantly improves the quality of life of patients (62.96%) by reducing the pain intensity (up to 81.48% of patients), retrieval of neurological function and movements of limbs (up to 70.37% of patients).

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