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Alloplasty of Thoracic and Lumbar Vertebrae in Patients with Malignant Cancer Metastases - Results, Hazards and Deviations

Grzegorz Guzik

Background: The increasing number of patients with malignant cancers and their prolonged survival resulting from progress in oncology contribute to development of complications in form of metastases to bones. They are usually located in the thoracic and the lumbar spine, causing tormenting pain, limiting performance, and decreasing quality of life. Correct qualifying of patients for various treatments, based on multi-specialist and comprehensive approach is of importance.

Methods: In this study results of surgical treatment for metastases using vertebral body prosthetic devices in the thoracic and lumbar spine were evaluated. 72 patients were operated in total. Indications for use of prostheses and selected surgical techniques were evaluated.

Results: The achieved results included improvement in performance assessed in accordance with the Karnofsky scale, reduction in pain intensity according to the VAS scale, and improvement in the neurological status in accordance with the Frankel scale. Complications were scarce. One patient suffered from permanent limb paralysis after the surgery.

Conclusions: Surgical treatment of metastases to the spine differs from standard procedures for traumatic or degenerative lesions. Different implants must be used, bone grafts are used rarely, and stabilisations are multi-segmental. The bone fusion does not guarantee a good treatment result.