The Journal of Bone and Joint Surgery, Vol 60, Issue 6 763-768, Copyright © 1978 by Journal of Bone and Joint Surgery, Inc
Metastatic tumors involving the cervical vertebrae: surgical palliation
JF Raycroft, RP Hockman and WO Southwick
Pain, weakness, or paralysis from involvement of the spinal cord and nerve
roots secondary to invasion of the vertebrae by a malignant tumor often can
be avoided or alleviated by stabilization of the spine. Twelve patients
with neoplastic infiltration of the cervical vertebrae were so treated. The
operation of wiring, augmentation bone-grafting, and decompression of the
spinal cord was successful after conservative methods failed. Indications
for operation were: (1) unremitting pain in the neck, not relieved by
bracing or radiation therapy; (2) a major degree of vertebral destruction
with loss, or impending loss, of support for the head; (3) collapse of a
vertebral body; or (4) neural deficit from local tumor invasion. A
classification of our twelve patients into three groups helped to delineate
the surgical procedure needed. The value of obtaining spinal stability and
a solid fusion above and below the tumor was evident in eleven patients.
For almost all of their survival time, they were comfortable. Surgical
treatment may not appreciably extend the lenght of a patient's survival,
but it generally improves the patient's quality of life.
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