The Journal of Bone and Joint Surgery, Vol 65, Issue 9 1283-1289, Copyright © 1983 by Journal of Bone and Joint Surgery, Inc
Surgical treatment of giant-cell tumor of the spine. The experience at the Istituto Ortopedico Rizzoli
R Savini, F Gherlinzoni, M Morandi, JR Neff and P Picci
We reviewed the cases of nine patients with a giant-cell tumor of the
vertebrae. All segments of the spine can be affected by the tumor, but
there was a predilection for the lumbar segments in our series. Pain was
present in all patients. The maximum duration before the diagnosis was made
was three years and the minimum, forty-five days (average, 12.2 months). In
six patients a neural deficit was also present. One patient was treated
many years ago by radiation therapy alone; three patients were treated by
decompressive laminectomy; two, by excision of the lesion and postoperative
radiation therapy; and three patients underwent lesional but extensive
excision as well as arthrodesis without any preoperative or postoperative
radiation therapy. We have obtained good results with the latter treatment;
after follow-ups of sixty, twenty-six, and twenty-four months in three
patients the pain and the neural symptoms subsided, while roentgenographic
examination showed no evidence of local recurrence. In all patients the
autogenous bone grafts appeared to be incorporated, without any secondary
deformity. We concluded that, due to the development of better surgical
techniques, the surgical approach is probably the best modern treatment for
a giant-cell tumor located in the spine.
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