Journal de la colonne vertébrale

Management of Metastatic Tumours to the Cervical Spine

Abstract

Pawel Zwolak and Markus Kröber

The spinal column is the most common site of skeletal secondary tumours. Metastatic tumours spreading to spine cause growing problem to the aging population. Patients suffer from immobilizing pain, instability of the spine and secondary neurologic deficits. In most patients treatment is palliative. By improving therapy of tumour-induced instability of the spine and tumour-induced pain, patients’ quality of life can be significantly improved and medical costs significantly lowered. In the past, the traditional therapy of metastatic spinal tumours was based on fractionated external beam radiotherapy. Surgical approach was limited to laminectomy (decompression). Nowadays, surgery focuses on preservation and restoration of neurologic function and stability of the spine by marginal resection, and immediate posterior and anterior stabilization. In addition, development of new surgical techniques such as radiofrequency thermoablation and kyphoplasty allowed surgeons address some of the problems related to lytic destruction of the vertebra without increasing morbidity and mortality of the patients associated with open surgery. However, proper treatment of the cervical spine metastases can be achieved only by multidisciplinary team work.