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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Instability of the spine caused by metastatic spread of primary tumors represents a serious risk for spinal cord or nerve root compression. In order to restore stability and relieve neural compression, a variety of surgical techniques originally used for reduction of nonpathologic spinal fractures have been applied to the problem of spinal metastases. Recently, we have utilized a technique developed primarily for correction of scoliosis to the treatment of metastatic spinal fractures. Six patients with spinal instability and neural compression secondary to metastatic tumors had segmental spinal stabilization with Luque rods, sublaminar wiring, and methyl methacrylate. Restoration of stability was successful in all cases with alleviation of preoperative pain and return to full activity. No evidence of instability occurred in this group of patients. As demonstrated by this experience and that of a few other small series, Luque rod stabilization provides a valuable addition to the techniques available for stabilization of metastatic fractures of the spine. Although the precise role of Luque rod segmental spinal stabilization in treatment of metastatic disease of the spine continues to be defined, thus far it has proved beneficial for cases of multiple vertebral body involvement or instability beyond one vertebral level.
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PMID:Luque rod stabilization for metastatic disease of the spine. 244 24

A variety of surgical techniques is available for treatment of metastatic disease of the spine. Prior emphasis on the use of these procedures has been on their benefit as a palliative measure to relieve signs and symptoms of spinal cord and nerve root compression not aided by radiation therapy and corticosteroid administration. More recently, development of surgical techniques that combine neural decompression with restoration of spinal stability has brought about consideration of additional indications for surgery in the treatment of metastatic disease of the spine. The present scope of such surgical procedures is reviewed along with identification of the most reliable selection factors for surgical candidates in order to improve functional outcome from surgical treatment of metastatic disease of the spine. Over 70 surgical series with more than 2,000 patients treated were reviewed.
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PMID:Methods of surgical stabilization for metastatic disease of the spine. 267 82

Four patients with a solitary vertebral metastasis from a renal cell carcinoma presented with acute spinal cord or nerve root compression. Because of the markedly hypervascular nature of the metastases it was decided to palliate the lesions by transarterial catheter embolization. The embolization reduced the venous blood pool within the tumors, resulting in progressive neurological improvement often lasting for 12 weeks or more. With such palliation, surgical decompression may be obviated, postponed, or at least made manageable.
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PMID:Embolization of solitary spinal metastases from renal cell carcinoma: alternative therapy for spinal cord or nerve root compression. 292 19

Since 1972, 18 patients suffering from metastatic cancer in the cervical spine were treated with prosthetic replacement surgery. The surgery enabled the authors to decompress the spinal cord and the nerve roots and at the same time restore stability in the affected spine. Patients suffering from severe pain and spinal cord and/or nerve root compression secondary to involvement of a single vertebral body particularly benefited from this surgery. The rates of positive recovery were as follows: 94.1% for pain relief, 91.7% for motor recovery, and 87.5% for ambulation. The surgical efficacy was maintained until the terminal stage. Tumor recurrence took place in five cases--two anterior, and three posterior. Anterior recurrence caused a marked instability, whereas posterior recurrence did not affect stability.
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PMID:Prosthetic replacement surgery for cervical spine metastasis. 319 92

Computertomography of the lumbar spine shows exactly shape and size of the spinal canal. CAT of Patient with chronic nerve root compression syndrom revealed mostly bony narrowness of the intervetebral notch, - foraminal entrapment -, and thickening of the laminae - laminar compression -. Following alterations were vissible by CT scanning Bony entrapment of the notch by degenerative hypertrophy of the facets. Idiopathic stenosis of the spinal canal. Developed stenosis of the spinal canal. Unilateral idiopathic narrowness of the recessus lateralis Spondylolysis. Postoperative calcification in the notch area. Prolapsed disc with and without contrastmedium Metastasis within L4 vertebra. Spondylitis tuberculosa.
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PMID:[CT-scanning of the lumbar spine (author's transl)]. 742 12

Metastatic bone disease from hormone-refractory prostate cancer can lead to significant morbidity such as pain, nerve compression and fractures which diminishes the quality of life of these patients substantially. Pain from osteoblastic metastases can significantly be improved by both external radiotherapy and Strontium-89 (89Sr), whereas lytic metastases are only responsive to external irradiation. Pain relief is obtained in approximately 80% of patients. Toxicity is mild and retreatment is usually possible. External beam radiotherapy is indicated when spinal cord or nerve root compression is demonstrated, or when osteolytic metastases with danger of fracture are visualized. External radiotherapy and Strontium-89 are important treatments to palliate patients suffering from metastatic prostate cancer. Because of their mild toxicity and highly effective analgesic effect, implementation of irradiation and 89Sr should be start of early in the disease process of these patients in order to keep them ambulatory and pain-free as long as possible.
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PMID:The treatment of osseous metastases of hormone-refractory prostate cancer with external beam radiotherapy and Strontium-89. 894 76

Ketoconazole has been used with success to treat disseminated intravascular coagulation and acute spinal cord compression syndromes associated with metastatic prostatic adenocarcinoma. It effects prompt, reversible medical castration, making it especially useful as empiric therapy when histologic diagnosis is delayed but prostate cancer is suspected. Side effects are usually limited to asthenia, nausea, diarrhea, and gynecomastia, but a theoretical risk of adrenal suppression exists. We report a case of fulminant adrenal crisis precipitated by ketoconazole given on a 6-hour dosing schedule in a patient with nerve root compression secondary to prostatic metastases. Through a review of the literature, we attempt to provide a better understanding of the use and potential dangers associated with ketoconazole therapy.
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PMID:Ketoconazole-induced adrenal crisis in a patient with metastatic prostatic adenocarcinoma: case report and review of the literature. 914 92

A 63-year-old man presented with a rare metastatic Merkel cell carcinoma (MCC) involving the lumbosacral spine and causing nerve root compression. Magnetic resonance (MR) imaging revealed an extradural soft tissue mass at the L5-S1 levels. The tumor was subtotally removed and chemotherapy was administered, but he died of multiple metastases from the primary epigastric tumor. Lumbosacral metastatic epidural tumor can manifest as lumbar disc disease symptoms, but MR imaging can non-invasively and rapidly reveal the presence of spinal epidural tumor and any extension to the spinal canal. Extradural MCC metastasis in the lumbosacral area should be considered in the differential diagnosis of radicular symptoms caused by disc herniation.
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PMID:Lumbosacral metastatic extradural Merkel cell carcinoma causing nerve root compression--case report. 1194 94

Nerve root and spinal cord compression are oncological emergencies that require early detection and prompt management. These phenomena are most frequently diagnosed in patients with haematogenous metastases from lung, breast and prostate cancers and are rarely seen in patients with squamous cell cancer of the head and neck (SCCHN). SCCHN tends to spread by direct extension and lymphatic metastasis, with haematogenous dissemination occurring late in the natural history of the disease. In this paper, we report three patients with residual or relapsed SCCHN who presented with symptoms and signs of nerve root compression affecting the upper limbs caused by locoregional lymphatic spread of disease.
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PMID:Residual or recurrent head and neck cancer presenting with nerve root compression affecting the upper limbs. 1532 51

Metastasis to the skeleton frequently occurs in breast carcinoma patients resulting in different skeletal-related events including pain, hypercalcemia, pathological fracture, and spinal cord or nerve root compression. Bisphosphonates are class of agents most frequently used to reduce skeletal-related events in patients with bone metastases by inhibiting osteoclast activity through inhibition of mevolanate pathway which is also important in cholesterol synthesis. Statins are cholesterol lowering agents and inhibit the same pathway. Therefore statins may also reduce skeletal-related events in breast cancer patients with bone metastases by inhibiting osteoclastic activity.
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PMID:Statins may decrease skeletal-related events in breast cancer patients with bone metastases. 1684 15


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