scholarly journals Outcomes and survival of spinal metastasis with epidural compression

2021 ◽  
Vol 12 (3) ◽  
pp. 287
Author(s):  
RômuloPedroza Pinheiro ◽  
PriscilaBarile Marchi Candido ◽  
FernandaMaris Peria ◽  
HertonRodrigo Tavares Costa ◽  
HeltonLuiz Aaparecido Defino
Keyword(s):  
Spinal Metastasis ◽  
Epidural Compression

scholarly journals UNKNOWN PRIMARY TUMOR SITES IN SPINAL METASTASIS

2021 ◽  
Vol 20 (1) ◽  
pp. 64-67
Author(s):  
Priscila Barile Marchi Candido ◽  
Rômulo Pedroza Pinheiro ◽  
Fernanda Maris Peria ◽  
Vinicius Nogueira Toledo ◽  
Herton Rodrigo Tavares Costa ◽  
...  
Keyword(s):  
Clinical Features ◽  
Primary Tumor ◽  
Spinal Metastasis ◽  
Survival Rates ◽  
Unknown Primary ◽  
Unknown Primary Tumor ◽  
Treatment Results ◽  
Level Of Evidence ◽  
Primary Tumor Site ◽  
Epidural Compression

ABSTRACT Objective: The goal of the study was to report the prevalence of spinal metastasis with unknown primary tumor, clinical features, treatment results and patient survival. Methods: A retrospective evaluation of 103 patients with spinal metastasis and epidural compression, who underwent surgical treatment between March 2009 and August 2015. The prevalence of metastatic spinal tumor with unknown primary tumor was evaluated, as well clinical features, survival and treatment results. Results: Of 103 patients with spinal metastasis and epidural compression, seven patients (6.8%) with unknown primary tumor site were identified; five (71.4%) male and two (28.6%) female, with ages ranging from 37 to 67 years (50.7 years). The metastasis was located in the thoracic spine in six of the patients (85.7%) and in the cervical spine in one (14.3%). The mean survival time was 44.8 days. Conclusion: Spinal metastasis with unknown primary tumor was found in 6.8% of patients. The prognosis and outcomes were poor, and patients had poor survival rates. Level of evidence III; Experimental study.

scholarly journals Spinal Laser Interstitial Thermal Therapy

Neurosurgery ◽  
2016 ◽  
Vol 79 (suppl_1) ◽  
pp. S73-S82 ◽  
Author(s):  
Claudio E. Tatsui ◽  
Sun-Ho Lee ◽  
Behrang Amini ◽  
Ganesh Rao ◽  
Dima Suki ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Systemic Therapy ◽  
Spinal Metastasis ◽  
Metastatic Tumor ◽  
Motor Deficits ◽  
Routine Practice ◽  
Safe Alternative ◽  
Scale Scores ◽  
Epidural Compression

Abstract BACKGROUND: Although surgery followed by radiation effectively treats metastatic epidural compression, the ideal surgical approach should enable fast recovery and rapid institution of radiation and systemic therapy directed at the primary tumor. OBJECTIVE: To assess spinal laser interstitial thermotherapy (SLITT) as an alternative to surgery monitored in real time by thermal magnetic resonance (MR) images. METHODS: Patients referred for spinal metastasis without motor deficits underwent MR-guided SLITT, followed by stereotactic radiosurgery. Clinical and radiological data were gathered prospectively, according to routine practice. RESULTS: MR imaging-guided SLITT was performed on 19 patients with metastatic epidural compression. No procedures were discontinued because of technical difficulties, and no permanent neurological injuries occurred. The median follow-up duration was 28 weeks (range 10-64 weeks). Systemic therapy was not interrupted to perform the procedures. The mean preoperative visual analog scale scores of 4.72 (SD ± 0.67) decreased to 2.56 (SD ± 0.71, P = .043) at 1 month and remained improved from baseline at 3.25 (SD ± 0.75, P = .021) 3 months after the procedure. The preoperative mean EQ-5D index for quality of life was 0.67 (SD ± 0.07) and remained without significant change at 1 month 0.79 (SD ± 0.06, P = .317) and improved at 3 months 0.83 (SD ± 0.06, P = .04) after SLITT. Follow-up MR imaging after 2 months revealed significant decompression of the neural component in 16 patients. However, 3 patients showed progression at follow-up, 1 was treated with surgical decompression and stabilization and 2 were treated with repeated SLITT. CONCLUSION: MR-guided SLITT can be both a feasible and safe alternative to separation surgery in carefully selected cases of spinal metastatic tumor epidural compression.

COMPLICATIONS OF SURGICAL TREATMENT OF SPINAL METASTASES

2021 ◽  
Vol 20 (4) ◽  
pp. 300-304
Author(s):  
Priscila Barile Marchi Candido ◽  
Fernanda Maris Peria ◽  
Vinicius Nogueira Toledo ◽  
Herton Rodrigo Tavares Costa ◽  
Helton Luiz Aparecido Defino
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Spinal Metastasis ◽  
Spinal Metastases ◽  
Tumor Location ◽  
Karnofsky Performance Scale ◽  
Tumor Type ◽  
Level Of Evidence ◽  
Epidural Compression ◽  
Performance Scale

ABSTRACT Objectives: To evaluate the complications of surgical treatment in a group of patients with spinal metastasis with epidural compression, undergoing surgical treatment. Methods: This is a comparative retrospective study (level of evidence III), which evaluated 96 patients with spinal metastases undergoing surgical treatment. Intra- and postoperative complications were obtained from the patients’ medical records and correlated with the following clinical characteristics: tumor type, tumor location, neurological deficit, age, number of affected vertebrae, Tokuhashi scale, Tomita scale, Karnofsky performance scale, and type of approach. Results: Complications of surgical treatment were observed in 29 (30.20%) patients. Surgical wound infection was the most frequent complication, observed in 15% of patients. Conclusions: Surgical treatment of spinal metastases presents complications in about 30% of patients and their occurrence should be considered in the treatment planning, weighing the risks and benefits for achieving the treatment goals. Level III evidence; Retrospective Study.

scholarly journals A COMPARISON OF THE TOMITA AND TOKUHASHI SCORES IN SPINAL METASTASIS

2020 ◽  
Vol 19 (4) ◽  
pp. 297-301
Author(s):  
PRISCILA BARILE MARCHI CANDIDO ◽  
FERNANDA MARIA PERRIA ◽  
HERTON RODRIGO DA COSTA ◽  
HELTON LUIZ APARECIDO DEFINO
Keyword(s):  
Surgical Treatment ◽  
Patient Survival ◽  
Spinal Metastasis ◽  
Survival Rates ◽  
Weighted Kappa ◽  
Kappa Coefficient ◽  
Level Of Evidence ◽  
Survival Group ◽  
Tokuhashi Score ◽  
Epidural Compression

ABSTRACT Objective To compare Tokuhashi and Tomita scores in patients with epidural spinal metastasis who underwent surgical treatment. Methods A retrospective evaluation of 103 patients with spinal metastasis and epidural compression who underwent surgical treatment. An analysis was performed of agreement between the survival rates observed in the study sample and the survival rate estimated by the Tomita and Tokuhashi scales. Results The overall accuracy was 39.03% for the Tomita scale and 61.75% for the Tokuhashi scale. Fair agreement (0.38 weighted Cohen’s Kappa coefficient) was observed between patient survival and the Tokuhashi score, and slight agreement (0.25 weighted Kappa coefficient) for the Tomita score. The agreement for both scales was higher for patients with less than six months’ survival, with general accuracy of 79.17% for the Tomita and 70.59% for the Tokuhashi scoring system. Conclusion There was fair and slight agreement between the Tokuhashi and Tomita scores with patient survival group. The agreement was higher for patients with less than six months’ survival. Level of evidence III; Comparative retrospective study.

Comparisons of MR Findings of the Spinal Metastasis and the Spinal Tuberculosis

1994 ◽  
Vol 31 (4) ◽  
pp. 743
Author(s):  
Sang Hoon Bae ◽  
Myung Sun Hong ◽  
Ku Sub Yun ◽  
Ik Won Kang ◽  
Kil Woo Lee ◽  
...  
Keyword(s):  
Spinal Metastasis ◽  
Spinal Tuberculosis

Intradural tumor recurrence after resection of extradural metastasis: a rare but potential complication of intraoperative durotomy

2014 ◽  
Vol 20 (6) ◽  
pp. 734-739 ◽  
Author(s):  
Manish K. Kasliwal ◽  
Lee A. Tan ◽  
John E. O'Toole
Keyword(s):  
Tumor Recurrence ◽  
Spinal Metastasis ◽  
Spinal Metastases ◽  
Intramedullary Tumor ◽  
Local Tumor ◽  
Local Tumor Recurrence ◽  
Tumor Dissemination ◽  
Intradural Tumor ◽  
Clinical Consequences ◽  
Clinical Awareness

Spinal metastases are the most common of spinal neoplasms and occur predominantly in an extradural location. Their appearance in an intradural location is uncommon and is associated with a poor prognosis. Cerebrospinal fluid dissemination accounts for a significant number of intradural spinal metastases mostly manifesting as leptomeningeal carcinomatoses or drop metastases from intracranial tumors. The occurrence of local tumor dissemination intradurally following surgery for an extradural spinal metastasis has not been reported previously. The authors describe 2 cases in which local intradural and intramedullary tumor recurrences occurred following resection of extradural metastases that were complicated by unintended durotomy. To heighten clinical awareness of this unusual form of local tumor recurrence, the authors discuss the possible etiology and clinical consequences of this entity.

scholarly journals Laser interstitial thermotherapy (LITT) for the treatment of tumors of the brain and spine: a brief review

2021 ◽  
Vol 151 (3) ◽  
pp. 429-442
Author(s):  
Clark Chen ◽  
Ian Lee ◽  
Claudio Tatsui ◽  
Theresa Elder ◽  
Andrew E. Sloan
Keyword(s):  
Brain Tumors ◽  
Minimally Invasive ◽  
Radiation Necrosis ◽  
Spinal Metastasis ◽  
Clinical Approach ◽  
Invasive Treatment ◽  
Primary Indication ◽  
Interstitial Thermotherapy ◽  
The Brain

Abstract Introduction Laser Interstitial Thermotherapy (LITT; also known as Stereotactic Laser Ablation or SLA), is a minimally invasive treatment modality that has recently gained prominence in the treatment of malignant primary and metastatic brain tumors and radiation necrosis and studies for treatment of spinal metastasis has recently been reported. Methods Here we provide a brief literature review of the various contemporary uses for LITT and their reported outcomes. Results Historically, the primary indication for LITT has been for the treatment of recurrent glioblastoma (GBM). However, indications have continued to expand and now include gliomas of different grades, brain metastasis (BM), radiation necrosis (RN), other types of brain tumors as well as spine metastasis. LITT is emerging as a safe, reliable, minimally invasive clinical approach, particularly for deep seated, focal malignant brain tumors and radiation necrosis. The role of LITT for treatment of other types of tumors of the brain and for spine tumors appears to be evolving at a small number of centers. While the technology appears to be safe and increasingly utilized, there have been few prospective clinical trials and most published studies combine different pathologies in the same report. Conclusion Well-designed prospective trials will be required to firmly establish the role of LITT in the treatment of lesions of the brain and spine.

Chiasmatic low-grade glioma presenting with sacral intradural spinal metastasis

2000 ◽  
Vol 16 (5) ◽  
pp. 309-311 ◽  
Author(s):  
Zıya Akar ◽  
Necmettin Tanriover ◽  
Ali M. Kafadar ◽  
Nurperi Gazioglu ◽  
Büge Oz ◽  
...  
Keyword(s):  
Spinal Metastasis ◽  
Low Grade Glioma ◽  
Low Grade

scholarly journals Utilization of laser interstitial thermotherapy guided by real-time thermal MRI as an alternative to separation surgery in the management of spinal metastasis

2015 ◽  
Vol 23 (4) ◽  
pp. 400-411 ◽  
Author(s):  
Claudio E. Tatsui ◽  
R. Jason Stafford ◽  
Jing Li ◽  
Jonathan N. Sellin ◽  
Behrang Amini ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Real Time ◽  
Spinal Cord Compression ◽  
Spinal Metastasis ◽  
Cord Compression ◽  
The Mean ◽  
Interstitial Thermotherapy

OBJECT High-grade malignant spinal cord compression is commonly managed with a combination of surgery aimed at removing the epidural tumor, followed by spinal stereotactic radiosurgery (SSRS) aimed at local tumor control. The authors here introduce the use of spinal laser interstitial thermotherapy (SLITT) as an alternative to surgery prior to SSRS. METHODS Patients with a high degree of epidural malignant compression due to radioresistant tumors were selected for study. Visual analog scale (VAS) scores for pain and quality of life were obtained before and within 30 and 60 days after treatment. A laser probe was percutaneously placed in the epidural space. Real-time thermal MRI was used to monitor tissue damage in the region of interest. All patients received postoperative SSRS. The maximum thickness of the epidural tumor was measured, and the degree of epidural spinal cord compression (ESCC) was scored in pre- and postprocedure MRI. RESULTS In the 11 patients eligible for study, the mean VAS score for pain decreased from 6.18 in the preoperative period to 4.27 within 30 days and 2.8 within 60 days after the procedure. A similar VAS interrogating the percentage of quality of life demonstrated improvement from 60% preoperatively to 70% within both 30 and 60 days after treatment. Imaging follow-up 2 months after the procedure demonstrated a significant reduction in the mean thickness of the epidural tumor from 8.82 mm (95% CI 7.38–10.25) before treatment to 6.36 mm (95% CI 4.65–8.07) after SLITT and SSRS (p = 0.0001). The median preoperative ESCC Grade 2 was scored as 4, which was significantly higher than the score of 2 for Grade 1b (p = 0.04) on imaging follow-up 2 months after the procedure. CONCLUTIONS The authors present the first report on an innovative minimally invasive alternative to surgery in the management of spinal metastasis. In their early experience, SLITT has provided local control with low morbidity and improvement in both pain and the quality of life of patients.

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