Role of Posterior Fixation Technique in Surgeries for Pathological Fractures of the Dorsal and Lumbar Spine Secondary to Neoplastic Causes
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- Category: Vol. 83, March 2015
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Role of Posterior Fixation Technique in Surgeries for Pathological Fractures of the Dorsal and Lumbar Spine Secondary to Neoplastic Causes, AHMED M. KOHEIL, MOSTAFA M.W. KOTB, MOHAMED MOHEY and ALAA ABDEL FATTAH
Abstract
Objective: The aim of this work is to evaluate the outcomes of surgical posterior decompression and fixation of pathological fractures secondary to metastasis in the dorsal and lumbar spine.
Methods: 15 patients having pathological fractures sec-ondary to metastasis in the dorsal and lumbar spine were included in this study and were operated upon using posterior decompression and fixation technique. Operative procedures included tumor debulking, subtotal resection, and gross total resection. Postoperatively, patients were evaluated and fol-lowed-up for their neurological integrity, deficits and outcome.
Results: 15 patients were operated upon posterior fixation technique. The median age of presentation in this study was 47 years. There was 8 males (54%) and 7 females (46%). In this study the main presentation of patients with metastatic fractures of the dorsal and lumbar spine was pain in all the 15 patients (100%), motor affection in 10 patients (67%), and sphincteric affection in 10 patients (67%). In this study the distribution of vertebral compression fracture for metastatic spine fractures was from the sixth dorsal vertebrae to the fifth lumbar vertebrae with 58% of the fractures in the dorsal spine and 42% in the lumbar spine. Postoperatively, In this study seven patients (47%) showed pain improvement, two patients (13%) showed motor power improvement and no patients showed any improvement in the sphincteric affection. The complication rate for management of metastatic fractures of the dorsal and lumbar spine was 33% (5 patients) equally distributed between wound infection, implant malposition, pulmonary embolism, DVT.
Conclusion: Our study confirms that posterior decompres-sion and fixation technique is generally safe, effective and well-tolerated by patients.
However, Studies have proven that the functional neuro-logical outcome following surgical posterior decompression and fixation is intimately influenced by several factors includ-ing; pre-operative neurological deficits, histopathology of the tumor and extent of surgical resection.