Spine oncology:
Gespeichert in:
| Weitere Verfasser: | |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, PA
Saunders
2009
|
| Schriftenreihe: | Orthopedic clinics of North America
40,1 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XI, 177 S. zahlr. Ill., graph. Darst. |
| ISBN: | 1437705146 9781437705140 |
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| 245 | 1 | 0 | |a Spine oncology |c guest ed. Rakesh Donthineni ... |
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| 300 | |a XI, 177 S. |b zahlr. Ill., graph. Darst. | ||
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| 490 | 1 | |a Orthopedic clinics of North America |v 40,1 | |
| 650 | 4 | |a Spinal Neoplasms |x surgery | |
| 650 | 4 | |a Spinal Neoplasms |x therapy | |
| 650 | 4 | |a Spine |x Cancer | |
| 650 | 4 | |a Spine |x Cancer |x Surgery | |
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Datensatz im Suchindex
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| adam_text | Contents
Preface xi
Rakesh Donthineni and Onder Of luoglu
Diagnosis and Staging of SpineTumors 1
Rakesh Donthineni
Persistent axial pain with or without neurologic changes should prompt workup for
a possible tumor of the spine. Metastatic disease is more predominant than primary
tumors, but still needs adequate evaluation before any management. The various
steps of evaluation, diagnosis, and staging are reviewed.
Management of Benign Tumors of the Mobile Spine 9
Alessandro Gasbarrini, Michele Cappuccio, Rakesh Donthineni, Stefano Bandiera,
and Stefano Boriani
In the treatment of primary tumors, complete local eradication is the main goal, as an
oncologically appropriate surgical treatment can substantially improve the progno¬
sis and even be considered a life-saving procedure. In deciding the best treatment
for primary bone tumors of the spine, the choice of surgery, radiation therapy, che¬
motherapy, selective arterial embolization, or other medical treatments alone or in
combination is based on diagnosis, staging, and a deep understanding of the biol¬
ogy and the behavior of each tumor. This article is a guide to diagnosing and treating
such rare tumors.
Primary Malignant Tumors of the Spine 21
Narayan Sundaresan, Gerald Rosen, and Stefano Boriani
Primary malignant tumors of the spine account for less than 5% of primary bone tu¬
mors. Data from the SEER program suggest that the most common bone sarcomas
are osteosarcoma, chondrosarcoma, Ewing s sarcoma, chordoma, and malignant
fibrous histiocytoma/fibrosarcoma. During the last two decades, tremendous prog¬
ress has been made in clinical aspects, surgical approaches, and reconstruction
with instrumentation at all levels of the spine. Stabilization procedures, including ver-
tebroplasty and kyphoplasty, have further allowed palliation of pain and symptom
relief from compression fractures. Improved radiation techniques have offered the
potential for improved local control. This article reviews the changes in surgical phi¬
losophy in the management of malignant spinal tumors during the past two decades.
Algorithms and Planning in Metastatic SpineTumors 37
YasuakiTokuhashi.Yasumitsu Ajiro, and Masashi Oshima
Metastatic spine tumors cause the loss of the supporting function of the spine
through vertebral destruction or invade and compress the spinal cord or cauda
Contents
equine. As a result, metastatic spine tumor causes severe pain, paralysis, or impair¬
ment of activities of daily living (ADL). Also, because the finding of metastatic foci in
the spine suggests a generalized disorder, life expectancy and treatment options
have many limitations. For this reason, treatment is primarily symptomatic, and
the major goals in selecting therapeutic modalities are to relieve pain, prevent paral¬
ysis, and improve ADL. This article discusses the selection of treatment for meta¬
static spine tumors and, in particular, the indications for surgical treatment.
Total En Bloc Spondylectomy for Spinal Tumors: Surgical Techniques
and Related Basic Background 47
Norio Kawahara, KatsuroTomita, Hideki Murakami, and Satoru Demura
The authors group has developed a new surgical technique of spondylectomy (ver-
tebrectomy) called total en bloc spondylectomy (TES). This technique is different
from spondylectomy in that it involves en bloc removal of the lesion, that is, removal
of the whole vertebra, body and lamina, as one compartment. The surgical tech¬
nique of TES has been remarkably improved based on adequate knowledge and
consideration of the surgical anatomy, physiology, and biomechanics of the spine
and spinal cord. Review of the developmental process of this operation leads to rec¬
ognition of the tips, pitfalls, and solutions.
Biomechanics and Materials of Reconstruction After Tumor Resection in the Spinal Column 65
Robert P. MelcherandJiirgen Harms
We initially review the general biomechanical principles that should be considered in
surgical reconstruction of spinal tumors. This will be further clarified by more de¬
tailed descriptions for individual spinal regions in the subsequent part of the article.
In the case of patients with spinal metastases, especially in patients with a median
survival time less than a few months, a thorough review of the risks and benefits re¬
garding surgical intervention must be discussed with the patient. However, once the
decision for surgery has been made, a biomechanically sound reconstruction should
be performed to help restore or maintain the patient s mobility.
Cervical and Thoracic Spine Tumor Management: Surgical Indications, Techniques,
and Outcomes 75
Christian Mazel, Laurent Balabaud, S. Bennis, and S. Hansen
Since the first pioneering work in the area of tumors of the spine, medical profes¬
sionals have sought to determine the proper role of spine surgery in the management
of spinal tumors. Experience has proven that spine surgery is effective in the treat¬
ment of spinal cord compression for decreasing pain and improving quality of life
with low rates of surgical complications. We use several staging systems to assess
the patient s prognosis, to determine the best type of tumoral resection in preoper-
ative surgical planning, and to provide guidance as to the best therapeutic option for
the patient. In the surgical treatment of spine tumors, one of two opposing strategies
must be chosen: (1) palliative surgery with cord decompression and spine stabiliza¬
tion or (2) curative surgery with en bloc radical resection of the tumor and stabiliza¬
tion. In this article, we describe indications and surgical techniques related to
cervical spinal tumors: fixation and laminectomy of the upper and lower cervical
spines, corporectomy, and partial and total vertebrectomy. For tumors of the cervi-
cothoracic region, the most frequent level of spine metastasis and thoracic spine tu¬
mors, we describe the fixation and laminectomy technique, en bloc tumor resection,
and partial and total vertebrectomy. The last part of the article addresses outcomes
Contents
following spinal surgery, including outcomes related to en bloc Pancoast Tobias tu¬
mor resection, malignant dumbbell schwanomas, and metastasis.
Lumbar Tumor Resections and Management 93
Todd Alamin and Robert Mayle
More than one-third of patients with cancer have vertebral metastases found at au¬
topsy. Primary and metastatic tumors to the spinal column can lead to pain, insta¬
bility, and neurologic deficit. Symptomatic lesions are most prevalent in the
thoracic spine (70%), followed by the lumbar spine (20%) and cervical spine
(10%). Lesions in larger vertebral bodies tend to be asymptomatic given the in¬
creased ratio between the diameter of the spinal canal and the traversing nerve
roots.
Sacral Tumors and Management 105
Peter Paul Varga, Istvan Bors, and Aron Lazary
The evaluation and complex treatments of sacral tumors require a multidisciplinary
approach. Because of the complex anatomy conditions and biomechanics of the
lumbo-pelvic junction, surgical treatment of sacral neoplasms is one of the most
challenging fields in spine. Here, diagnostic process and surgical and nonsurgical
treatment options for sacral tumors are summarized based on the literature and
on the authors own experiences.
Complications of En Bloc Resections in the Spine 125
Stefano Bandiera, Stefano Boriani, Rakesh Donthineni, L. Amendola, Michele Cappuccio,
and Alessandro Gasbarrini
Morbidity of surgical procedures for spine tumors is expected to be worse than for
other conditions. This is particularly true for en bloc resections, a technically de¬
manding procedure. En bloc resections can help improve the prognosis of aggres¬
sive benign and malignant tumors in the spine, but the related morbidity is high and
sometimes fatal. Reoperations have higher risks because of dissection through scar/
fibrosis from previous surgeries and possibly from radiation. Careful planning for
treatment is mandatory, and if the surgeon is unsure, referral to a specialty center
is necessary.
Radiation for Spinal Metastatic Tumors 133
Patrick S. Swift
Radiotherapeutic management of vertebral metastases varies based on the extent
of disease within the spine and systemically, the histology of the tumor, and the
life expectancy of the patient. The goals of pain reduction, structural stability of
the axial skeleton, and maintenance of local control for the remainder of the patient s
life guide the decision to proceed with a short simple course of standard therapy or
a more complex approach with stereotactic regimens. The complex and rigorous
processes involved in stereotactic radiotherapy for the spine require close cooper¬
ation among the radiation oncologist, neurosurgeon, orthopedic surgeon, and med¬
ical oncologist, but the clinical results show that the result is an enhanced quality of
life for the patient.
Contents
Solitary Vertebral Metastasis 145
Daniel M. Sciubba.Trang Nguyen, and Ziya L. Gokaslan
As survival time increases for many cancers, it is likely that the incidence and prev¬
alence of spinal metastases will increase also. Given that most patients first present
with solitary lesions in the spine, proper initial diagnosis and management are of par¬
amount importance in minimizing pain, improving neurologic function, and poten¬
tially lengthening survival. Although pain control and standard radiation are still
used, spinal stereotactic radiosurgery, vertebroplasty and kyphoplasty, and spinal
cord decompression and fusion are now consistently used in aggressive manage¬
ment and offer exciting preliminary results.
Minimally Invasive Management of Spinal Metastases 155
OnderOfluoglu
In most patients who have spinal metastases, treatment is mainly palliative. The con¬
ventional surgical methods carry higher risks of complications and postoperative
morbidity. Minimally invasive spinal interventions seem to be reasonable alternatives
to treat spinal metastatic disease. These procedures can result in less soft tissue
trauma, lower blood loss, shorter hospitalization time and are better tolerated by
the patients. In this review, the techniques and results of minimally invasive manage¬
ment in spinal metastasis, including percutaneous image-guided interventions (ver¬
tebroplasty, kyphoplasty, and radiofrequency ablation) and minimally invasive
surgical techniques (endoscopic and minimal access operations), are presented.
Spine Oncology: Daedalus,Theseus, and the Minotaur 169
Rakesh Donthineni and Onder Of luoglu
Over the past three decades, progress has been dramatic in the management of
spine tumors. For example, advanced imaging technologies made available at man¬
ageable costs have lowered the threshold for scanning. CT, MRI, and PET imaging
modalities have greatly enhanced the ability of the surgeon to accurately delineate
the extension of the lesion within the bone, the soft tissue, and the spinal canal.
Such enhancements have led to great leaps forward in preoperative planning and
postoperative evaluation, including improved reconstruction options are resulting
in improved outcomes. This article introduces the theme of this volume.
Index I73
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| spelling | Spine oncology guest ed. Rakesh Donthineni ... Philadelphia, PA Saunders 2009 XI, 177 S. zahlr. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Orthopedic clinics of North America 40,1 Spinal Neoplasms surgery Spinal Neoplasms therapy Spine Cancer Spine Cancer Surgery Spine Cancer Treatment Donthineni, Rakesh (DE-588)137183887 edt Orthopedic clinics of North America 40,1 (DE-604)BV000001089 40,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=017079607&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Spine oncology Orthopedic clinics of North America Spinal Neoplasms surgery Spinal Neoplasms therapy Spine Cancer Spine Cancer Surgery Spine Cancer Treatment |
| title | Spine oncology |
| title_auth | Spine oncology |
| title_exact_search | Spine oncology |
| title_full | Spine oncology guest ed. Rakesh Donthineni ... |
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| title_full_unstemmed | Spine oncology guest ed. Rakesh Donthineni ... |
| title_short | Spine oncology |
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| topic | Spinal Neoplasms surgery Spinal Neoplasms therapy Spine Cancer Spine Cancer Surgery Spine Cancer Treatment |
| topic_facet | Spinal Neoplasms surgery Spinal Neoplasms therapy Spine Cancer Spine Cancer Surgery Spine Cancer Treatment |
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