DECOMPRESSIVE LAMINECTOMY IN PATIENTS WITH SPINE METASTASIS

Abstract

The aim is to present the experience of treating patients with spinal metastases, who underwent decompression laminectomy with posterior stabilization.Material and methods. The study included 326 patients with spine metastasis, who underwent posterior thoracic laminectomy (199, 61 %) and lumbar laminectomy (127, 39 %). The mean age of patients was 63 (range, 29–78 years). There were 91 (28 %) males and 235 (72 %) females. Breast cancer was diagnosed in 137 (42 %) patients, kidney cancer in 69 (21 %) patients, prostate cancer in 39 (12 %) patients, lung cancer in 19 (6 %) patients, colorectal cancer in 16 (5 %) patients, thyroid cancer in 13 (4 %) patients, and the remaining 10 % of patients accounted for other more rare forms of malignanciesResults. The mean time of surgery was 95 min. (55–245 min.). Intraoperative blood loss volume was 245 ml (150–3200 ml). The mean hospital stay was 8 days (5–20 days). The pain intensity according to vas reduced in 160 (49 %) patients. According to the frankel classification system, neurological status improved in 85 (26 %) patients. Neurological deterioration was observed in 7 (2 %) patients. Intra-and early-/late postoperative complications were observed in 66 (20 %) patients. Traumatic dural tears occurred in 16 (5 %) patients. Infection rate was 4.5 %. Cardiac complications were observed in 12 (3.5 %) patients. Postoperative hematoma was revealed in 7 (2.4 %) patients.Conclusion. The results obtained indicate that patients with metastatic spine disease represent a difficult group of patients for surgical treatment because of a high risk of developing postoperative complications, the most serious of which are neurological disorders with paraplegia and other fatal outcomes. Nevertheless, modern surgical techniques can improve the quality of life of these patients, improve psycho-emotional abilities and avoid disability.