| Neurological recovery after posterior decompression surgery for anterior dural compression in paralytic spinal metastasis. | |
| | |
MedLine Citation:
|
PMID: 22327407 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
PURPOSE: Paralysis in spinal metastasis is often caused by anterior dural compression, and anterior approach has been frequently chosen for decompression despite its dreadful complications. On the other hand, the effectiveness of posterior indirect decompression has not specifically established. The objective of the present study was to investigate the anatomical patterns of dural compression, and to clarify the effectiveness of posterior surgery for anterior lesions. METHODS: We retrospectively analyzed the anatomical patterns of spinal metastasis on MRI images and the neurological recovery in the paralytic patients who underwent posterior decompression and fusion surgery with intraoperative radiation therapy. The recovery rate was compared between those with an anterior or circumferential dural compression (A+), who were indirectly decompressed, and those with a posterior and/or lateral dural compression (A-), who were directly decompressed. RESULTS: A total of 135 cases were included in the study, and 81.5% had anterior dural compression (A+). In the A+ group, 88.2% of preoperatively non-ambulatory cases regained the gait. Full recovery was achieved in 50% of preoperatively ambulatory cases. These rates were not significantly different from those in the A- group. The rate of gait regain was diminished in the surgeries of the middle thoracic spine (T5-8). CONCLUSIONS: Most spinal metastases cause paralysis by anterior compression; however, the result of posterior indirect decompression was similar to that of posterior direct decompression, although kyphosis negatively affected the result. Anterior decompression might not always be necessary for soft tumor compression as long as the adjuvant therapy is effective for the local control. |
| | |
Authors:
|
So Kato; Takahiro Hozumi; Katsushi Takeshita; Taiji Kondo; Takahiro Goto; Kiyofumi Yamakawa |
Related Documents
:
|
22811157 - 168 moyamoya syndrome associated with neurofibromatosis type 1 in children: periopera... 22461247 - Vertebroplasty and balloon kyphoplasty in osteoporosis: friends or foes? 22527157 - Percutaneous transsplenic embolization of jejunal varices in a patient with liver cirrh... 22669967 - An unusual cause of lower gastrointestinal haemorrhage. 3287977 - Delayed presentation of blunt splenic injury. 15534517 - Factors influencing wear and osteolysis in press-fit condylar modular total knee replac... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2012-2-14 |
Journal Detail:
|
Title: Archives of orthopaedic and trauma surgery Volume: - ISSN: 1434-3916 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
|
Created Date: 2012-2-13 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9011043 Medline TA: Arch Orthop Trauma Surg Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
Department of Orthopaedic Surgery and Musculoskeletal Oncology, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan, sokato34@gmail.com. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The effects of parent-child relationships on later life mental health status in two national birth c...
Next Document: At the edge? HIV stigma and centrality in a community's social network in Namibia.