Title of article :
Role of Posterior Fixation Technique in Surgeries for Pathological Fractures of the Dorsal and Lumbar Spine Secondary to Neoplastic Causes
Author/Authors :
KOHEIL, AHMED M. Cairo University - Faculty of Medicine - Department of Neurosurgery, Egypt , KOTB, MOSTAFA M.W. Cairo University - Faculty of Medicine - Department of Neurosurgery, Egypt , MOHEY, MOHAMED Cairo University - Faculty of Medicine - Department of Neurosurgery, Egypt , ABDEL FATTAH, ALAA Cairo University - Faculty of Medicine - Department of Neurosurgery, Egypt
From page :
293
To page :
298
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 secondary 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 followed-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 decompression and fixation technique is generally safe, effective and well-tolerated by patients. However, Studies have proven that the functional neurological outcome following surgical posterior decompression and fixation is intimately influenced by several factors including; pre-operative neurological deficits, histopathology of the tumor and extent of surgical resection.
Keywords :
Metastasis , Posterior decompression , Posterior fixation , Neurological deficits
Journal title :
The Medical Journal of Cairo University
Journal title :
The Medical Journal of Cairo University
Record number :
2541358
Link To Document :
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