Abstract
Background and Objectives: The treatment of bony lesions along the vertebral axis has unique consideration owing to their inaccessibility, close proximity to the spinal cord and major vessels and potential postoperative instability requiring stabilization In this retrospective study we evaluated the surgical results of our patients with vertebral body tumors in a 25 year period. No similar study has been performed in our country yet.
Materials and Methods: In this study the surgical results of 84 patients among 169 serial cases with vertebral body tumors operated from1982 to 2007 are presented. Age, sex, duration and type of symptoms, topographical locations, radiological and surgical results, histological features and outcome are analyzed.
Results: This study is based on the clinical data of 84 surgically treated cases among 169 serial patients visited in the senior author’s clinic. 59.5% of the patients were male whereas 40.5% were female. The average age of our patients was 39 y (range: 6-82 y).The most common presenting symptom was axial pain (95.2%). The most common location of the tumor was the lumbar region (48.8 %), followed by the thoracic region (44.0%). In 71.4% the vertebral tumor was primary whereas in 28.6& it was metastatic.. The most common primary vertebral body tumor was osteoid osteoma. Gross and near total removal of the lesion was possible in 82.1% of cases.28.6 % of our patients needed instrumentation for stabilization. The patients were followed between 1-74 months, (mean=13.3 mo). Following surgical and adjunctive treatments, 91.7 % of the patients improved. Complications of surgery occurred in 7.1 % of cases and the mortality rate was 1.2 %.
Conclusions: In the management of vertebral tumors, the patients need individualized approaches and treatment plans in view of the variations in tumor aggressiveness, spinal level, location within the vertebral body or posterior elements, involvement of soft tissues and structures surrounding the vertebral column, neurological deficits, and spinal instability. Complete surgical excision of vertebral tumors without contamination of the surgical wound is not always possible, and adjuvant therapy by chemotherapy and/or radiation therapy is important to improve local and disease free survival. With the use of modern micro neurosurgical techniques and judicious use of arthrodesis and instrumentation, the surgical results in our patients were comparable with the reported results in developed countries.