SPINAL TUMORS: A CONCEPT OF INTEGRATED ASSESSMENT IN RELATION TO EMERGENCY CONDITIONS
https://doi.org/10.14531/ss2018.3.92-99
Abstract
A modern concept of assessing tumor lesions of the spine, NOMS, adapted to the conditions of emergency care is presented as a part of a systematic review of the literature. Principles of neurological, oncological, mechanical and system analysis of spine lesions in primary and metastatic spinal tumors, which are the basis for step-by-step tactical decisions, as well as methods for analyzing each component are described.
About the Authors
M. A. Mushkin
Pavlov First Saint-Petersburg State Medical University
Russian Federation
Russian Federation
orthopedic traumatologist, teaching assistance, Department of traumatolofy and orthopaedics
Lev Tolstoy str., 6–8, St. Petersburg 194064, Russia
A. K. Dulaev
Pavlov First Saint-Petersburg State Medical University; Saint-Petersburg Research Institute of Emergency Medicine n.a. I.I. Dzhanelidze
Russian Federation
Russian Federation
DMSc, Prof., Head of the Urban Center for Emergency Surgery of the Spine, St. Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine, Budapeshtskaya str., 3a, St. Petersburg, 192242, Russia;
Head of the Department of traumatology and orthopedics, Pavlov First Saint Petersburg State Medical University, Lev Tolstoy str., 6–8, St. Petersburg, 194064, Russia
A. Yu. Mushkin
Research Institute of Phthisiopulmonology Health Ministry of Russian Federation
Russian Federation
Russian Federation
DMSc, Prof., chief researcher
Politekhnicheskaya str., 32, St. Petersburg, 194064, Russia
References
1. Мушкин А.Ю., Мальченко О.В. Онкологическая вертебрология: избранные вопросы. Новосибирск, 2012.
2. Щербук Ю.А., Багненко С.Ф., Дулаев А.К., Дулаева Н.М., Аликов З.Ю. Организация специализированной медицинской помощи пациентам с неотложной хирургической патологией позвоночника. Хирургия позвоночника. 2011. № 2. С. 67-73. DOI: https://doi.org/10.14531/ss2011.2.67-73.
3. Bailar JC 3rd, Gornik HL. Cancer undefeated. N Eng J Med. 1997;336:1569-1574. DOI: 10.1056/NEJM199705293362206.
4. Bartolozzi B, Nozzoli C, Pandolfo C, Antonioli E, Guizzardi G, Morichi R, Bosi A. Percutaneous vertebroplasty and kyphoplasty in patients with multiple myeloma. Eur J Haematol. 2006;76:180-181. DOI: 10.1111/j.1600-0609.2005.00573.x.
5. Bilsky MH, Laufer I, Fourney DR, Groff M, Schmidt MH, Varga PP, Vrionis FD, Yamada Y, Gerszten PC, Kuklo TR. Reliability analysis of the epidural spinal cord compression scale. J Neurosurg: Spine. 2010;13:324-328. DOI: 10.3171/2010.3.SPINE09459.
6. Bilsky MH, Lis E, Raizer J, Lee H, Boland P. The diagnosis and treatment of metastatic spinal tumor. Oncologist. 1999;4:459-469.
7. Burton AW, Mendel E. Vertebroplasty and kyphoplasty. Pain Physician. 2003;6:335-341.
8. Chow E, Harris K, Fan G, Tsao M, Sze WM. Palliative radiotherapy trials for bone metastases: a systematic review. J Clin Oncol. 2007;25:1423-1436. DOI: 10.1200/JCO.2006.09.5281.
9. Cooper PR, Errico TJ, Martin R, Crawford B, DiBartolo T. A systematic approach to spinal reconstruction after anterior decompression for neoplastic disease of the thoracic and lumbar spine. Neurosurgery. 1993;32:1-8. DOI: 10.1227/00006123-199301000-00001.
10. Findlay GF. Adverse effects of the management of malignant spinal cord compression. J Neurol Neurosurg Psychiatry. 1984;47:761-768.
11. Fisher CG, DiPaola CP, Ryken TC, Bilsky MH, Shaffrey CI, Berven SH, Harrop JS, Fehlings MG, Boriani S, Chou D, Schmidt MH, Polly DW, Biagini R, Burch S, Dekutoski MB, Ganju A, Gerszten PC, Gokaslan ZL, Groff MW, Liebsch NJ, Mendel E, Okuno SH, Patel S, Rhines LD, Rose PS, Sciubba DM, Sundaresan N, Tomita K, Varga PP, Vialle LR, Vrionis FD, Yamada Y, Fourney DR. A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group. Spine. 2010;35:E1221-E1229. DOI: 10.1097/BRS.0b013e3181e16ae2.
12. Fourney DR, Frangou EM, Ryken TC, Dipaola CP, Shaffrey CI, Berven SH, Bilsky MH, Harrop JS, Fehlings MG, Boriani S, Chou D, Schmidt MH, Polly DW, Biagini R, Burch S, Dekutoski MB, Ganju A, Gerszten PC, Gokaslan ZL, Groff MW, Liebsch NJ, Mendel E, Okuno SH, Patel S, Rhines LD, Rose PS, Sciubba DM, Sundaresan N, Tomita K, Varga PP, Vialle LR, Vrionis FD, Yamada Y, Fisher CG. Spinal instability neoplastic score: an analysis of reliability and validity from the spine oncology study group. J Clin Oncol. 2011;29:3072-3077. DOI: 10.1200/JCO.2010.34.3897.
13. Gerszten PC, Burton SA, Ozhasoglu C, Welch WC. Radiosurgery for spinal metastases: clinical experience in 500 cases from a single institution. Spine. 2007;32:193-199. DOI: 10.1097/01.brs.0000251863.76595.a2.
14. Gerszten PC, Burton SA, Ozhasoglu C, Vogel WJ, Welch WC, Baar J, Friedland DM. Stereotactic radiosurgery for spinal metastases from renal cell carcinoma. J Neurosurg: Spine. 2005;3:288-295. DOI: 10.3171/spi.2005.3.4.0288.
15. Gerszten PC, Mendel E, Yamada Y. Radiotherapy and radiosurgery for metastatic spine disease: what are the options, indications, and outcomes? Spine. 2009;34:S78-S92. DOI: 10.1097/BRS.0b013e3181b8b6f5.
16. Gokaslan ZL, York JE, Walsh GL, McCutcheon IE, Lang FF, Putnam JB Jr, Wildrick DM, Swisher SG. Transthoracic vertebrectomy for metastatic spinal tumors. J Neurosurg. 1998;89:599-609. DOI: 10.3171/jns.1998.89.4.0599.
17. Hatrick NC, Lucas JD, Timothy AR, Smith MA. The surgical treatment of metastatic disease of the spine. Radiother Oncol. 2000;56:335-339.
18. Heary RF, Bono CM. Metastatic spinal tumors. Neurosurg Focus. 2001;11:e1. DOI: 10.3171/foc.2001.11.6.2.
19. Hentschel SJ, Burton AW, Fourney DR, Rhines LD, Mendel E. Percutaneous vertebroplasty and kyphoplasty performed at a cancer center: refuting proposed contraindications. J Neurosurg: Spine. 2005;2:436-440.
20. Ibrahim A, Crockard A, Antonietti P, Boriani S, Bunger C, Gasbarrini A, Grejs A, Harms J, Kawahara N, Mazel C, Melcher R, Tomita K. Does spinal surgery improve the quality of life for those with extradural (spinal) osseous metastases? An international multicenter prospective observational study of 223 patients. J Neurosurg: Spine. 2008;8:271-278.
21. Jacobs WB, Perrin RG. Evaluation and treatment of spinal metastases: an overview. Neurosurg Focus. 2001;11:e10.
22. Laufer I, Rubin DG, Lis E, Cox BW, Stubblefield MD, Yamada Y, Bilsky MH. The NOMS framework: approach to the treatment of spinal metastatic tumors. Oncologist. 2013;18:744-751. DOI: 10.1634/theoncologist.2012-029.
23. Lovelock DM, Zhang Z, Jackson A, Keam J, Bekelman J, Bilsky M, Lis E, Yamada Y. Correlation of local failure with measures of dose insufficiency in the high-dose single-fraction treatment of bony metastases. Int J Radiat Oncol Biol Phys. 2010;77:1282-1287. DOI: 10.1016/j.ijrobp.2009.10.003.
24. Maranzano E, Latini P. Effectiveness of radiation therapy without surgery in metastatic spinal cord compression: final results from a prospective trial. Int J Radiat Oncol Biol Phys. 1995;32:959-967. DOI: 10.1016/0360-3016(95)00572-G.
25. Mazel C, Balabaud L, Bennis S, Hansen S. Cervical and thoracic spine tumor management: surgical indications, techniques, and outcomes. Orthop Clin North Am. 2009;40:75-92. DOI: 10.1016/j.ocl.2008.09.008.
26. Mendel E, Bourekas E, Gerszten P, Golan JD. Percutaneous techniques in the treatment of spine tumors: what are the diagnostic and therapeutic indications and outcomes? Spine. 2009;34:S93-S100. DOI: 10.1097/BRS.0b013e3181b77895.
27. Patchell RA, Tibbs PA, Regine WF, Payne R, Saris S, Kryscio RJ, Mohiuddin M, Young B. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet. 2005;366:643-648. DOI: 10.1016/S0140-6736(05)66954-1.
28. Rades D, Fehlauer F, Schulte R, Veninga T, Stalpers LJ, Basic H, Bajrovic A, Hoskin PJ, Tribius S, Wildfang I, Rudat V, Engenhart-Cabilic R, Karstens JH, Alberti W, Dunst J, Schild SE. Prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression. J Clin Oncol. 2006;24:3388-3393. DOI: 10.1200/JCO.2005.05.0542.
29. Ryu S, Fang Yin F, Rock J, Zhu J, Chu A, Kagan E, Rogers L, Ajlouni M, Rosenblum M, Kim JH. Image-guided and intensity-modulated radiosurgery for patients with spinal metastasis. Cancer. 2003;97:2013-2018. DOI: 10.1002/cncr.11296.
30. Ryu S, Rock J, Rosenblum M, Kim JH. Patterns of failure after single-dose radiosurgery for spinal metastasis. J Neurosurg. 2004;101 Suppl 3:402-405. DOI: 10.3171/jns.2004.101.supplement 3.0402.
31. Sahgal A, Atenafu EG, Chao S, Al-Omair A, Boehling N, Balagamwala EH, Cunha M, Thibault I, Angelov L, Brown P, Suh J, Rhines LD, Fehlings MG, Chang E. Vertebral compression fracture after spine stereotactic body radiotherapy: a multi-institutional analysis with a focus on radiation dose and the spinal instability neoplastic score. J Clin Oncol. 2013;31:3426-3431. DOI: 10.1200/JCO.2013.50.1411.
32. Sakaura H, Hosono N, Mukai Y, Ishii T, Yonenobu K, Yoshikawa H. Outcome of total en bloc spondylectomy for solitary metastasis of the thoracolumbar spine. J Spinal Disord Tech. 2004;17:297-300.
33. Spinazze S, Caraceni A, Schrijvers D. Epidural spinal cord compression. Crit Rev Oncol Hematol. 2005;56:397-406. DOI: 10.1016/j.critrevonc.2005.04.005.
34. Steinmetz MP, Mekhail A, Benzel EC. Management of metastatic tumors of the spine: strategies and operative indications. Neurosurg Focus. 2001;11:1-6.
35. Sundaresan N, Digiacinto GV, Hughes JE, Cafferty M, Vallejo A. Treatment of neoplastic spinal cord compression: results of a prospective study. Neurosurgery. 1991;29:645-650.
36. Tokuhashi Y, Matsuzaki H, Oda H, Oshima M, Ryu J. A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine. 2005;30:2186-2191.
37. Tomita K, Kawahara N, Kobayashi T, Yoshida A, Murakami H, Akamaru T. Surgical strategy for spinal metastases. Spine. 2001;26:298-306.
38. Wai EK, Finkelstein JA, Tangente RP, Holden L, Chow E, Ford M, Yee A. Quality of life in surgical treatment of metastatic spine disease. Spine. 2003;28:508-512. DOI: 10.1097/00007632-200303010-00018.
39. Wang JC, Boland P, Mitra N, Yamada Y, Lis E, Stubblefield M, Bilsky MH. Single-stage posterolateral transpedicular approach for resection of epidural metastatic spine tumors involving the vertebral body with circumferential reconstruction: results in 140 patients. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004. J Neurosurg: Spine. 2004;1:287-298. DOI: 10.3171/spi.2004.1.3.0287.
40. Weigel B, Maghsudi M, Neumann C, Kretschmer R, Muller FJ, Nerlich M. Surgical management of symptomatic spinal metastases. Postoperative outcome and quality of life. Spine. 1999;24:2240-2246.
41. Wise JJ, Fischgrund JS, Herkowitz HN, Montgomery D, Kurz LT. Complication, survival rates, and risk factors of surgery for metastatic disease of the spine. Spine. 1999;24:1943-1951.
42. Yamada Y, Katsoulakis E, Laufer I, Lovelock M, Barzilai O, McLaughlin LA, Zhang Z, Schmitt AM, Higginson DS, Lis E, Zelefsky MJ, Mechalakos J, Bilsky MH. The impact of histology and delivered dose on local control of spinal metastases treated with stereotactic radiosurgery. Neurosurg Focus. 2017;42:E6. DOI: 10.3171/2016.9.FOCUS16369.
43. Young RF, Post EM, King GA. Treatment of spinal epidural metastases: randomized prospective comparison of laminectomy and radiotherapy. J Neurosurg. 1980;53:741-748. DOI: 10.3171/jns.1980.53.6.0741.
Review
For citations:
Mushkin M.A., Dulaev A.K., Mushkin A.Yu. SPINAL TUMORS: A CONCEPT OF INTEGRATED ASSESSMENT IN RELATION TO EMERGENCY CONDITIONS. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2018;15(3):92-99. https://doi.org/10.14531/ss2018.3.92-99
Email this article 