A retrospective analysis was performed in 107 patients who, between January 1993 and December 1998, underwent a surgical intervention for symptomatic spinal metastases at the Department of Orthopaedic Surgery, Martin-Luther-University Halle-Wittenberg. Main primary tumors of the spinal metastases had been cancer of the breast, kidney, lung and non-Hodgkin's lymphoma. The mean postoperative survival time was 16,5 month. Survival was closely related to the primary lesions. The highest survival rates were seen at patients with non-Hodgkin's lymphoma (30 month) and breast carcinoma (20 month). Patients with lung carcinoma showed the poorest survival rates with 8 month. Statistical analysis showed that the length of postoperative survival time was significantly associated with additional visceral metastases. Patients with metastases of the lung or kidney had significantly a shorter survival time than patients without visceral metastases. The majority of tumors involved thoracic spine (41,1%) and lumbar spine (47,7%). A posterior decompression with stabilisation was used in 85,1% of surgery. In 13,0% the patients were treated with a combined surgical therapy with anterior resection of the vertebral body, implantation of a spacer and posterior stabilisation. 32 Patients (29,9%) showed postoperative complications, most of them had complications of the wound healing (8,4%). After surgery 70% of patients reported pain reduction. Postoperativly most of the patients stated by a better quality of life. An unfavourable prognosis have rapid growth primary tumors, multiple bone metastases and visceral metastases. |