Vertebral Body Trauma Essay

SURVIVAL AND FUNCTIONAL RESULTS OF THE SINGLE STAGE CORPECTOMY PROCEDURE IN THE MANAGEMENT OF PATHOLOGIC FRACTURES OF VERTEBRAE

INTRODUCTION

Spinal metastases show an apparent predilection for vertebral body and frequently result in pathologic fractures of the vertebra. Vertebral body involvement is one of the primary cause of morbidity and mortality in patients with advanced malignancy. Hence, vertebral body involvement can be accepted as an indicator of aggressivity of primary malignancy. Additionally, neurologic symptoms due to instability may be the first presentation of the spinal involvement in such patients; moreover, impairment is the fundamental reason for the surgical intervention. Surgical intervention can endow adequate stability

Approximately % 10 of all cancer patients develop spinal metastases (3) Half of all metastases in the spine is in the thoracic vertebra, followed by the lumbar and cervical vertebra (4,5,6). When an involvement occurs in the spine, vertebral body is the most frequent site ( followed by the pedicles and posterior elements ) and often leads to pathologic fracture (7). Plexus of Batson is used by malignant cells via hematogenous spread by virtue of lacking valves (8) The vertebral involvement in cancer patients deteriorates the course of the malignancy and not only reduces the patients quality of life but also increase the ratio of mortality. One of the determinants of the low quality of life in cancer patients that mentioned above is the pathologic fracture of the vertebra. It is reported that the incidence of pathologic fractures of the vertebra in patients with malignancy is approximately % 10 (9). Although the most of the patients with spinal metastases are asymptomatic, approximately one- third of patients could become symptomatic and present themselves with refractory pain and neurological impairment (10,11) Persistent back pain and neurologic dysfunction due to neural compression and spinal instability are characteristic symptoms in symptomatic spinal metastases (12). When does the surgical intervention necessary is still a matter of debate. Moreover, do the surgical procedures extend the lifespan of the patients with spinal metastases is unknown. We aimed to evaluate the effectiveness of the specific procedure, called corpectomy, to cancer patients with pathologic fracture of the spine and contribution to survive. The primary purposes of the management of the symptomatic patients with spinal metastases have reduced the intractable pain, maintenance of spinal stability, achieving the functional independence and sustaining the ambulation. Various treatment modalities are available,