Multifocal spine methastasis – early surgical treatment results

Introduction. Constantly increasing number of patients with cancer. The significant development of oncology and the introduction of new treatments al- lowed explicitly extend the life expectancy of cancer patients at the cost of increasingly revealing the late complications. Aim. Presentation of methods, problems and early results of multi-site treatment of spinal metastases in the Department of Orthopaedic Oncology Hospital in Brzozow. Materials and methods. In the Department from 2010 to 2016 due to spinal metastases were treated 541 patients. Preoperative planning included quality of life in Karnofsky scale assesment, pain VAS scale and the presence of neurological deficits in Frankel scale. Morphology metastases of all 541 were classified due to numbers of lesions and location. Surgical treatment was rated due to chosen approach. Results. In 411 patients who underwent surgery, a reduction of pain VAS scale was obtained. From the 91 patients with paresis in 23 patients achieved clinical improvement. Quality of life assessed on a scale Karnofskyego increased in 305 patients. In the group of 80 non-ambulatory patients 18 patients improvement of neurological re-enabled vertical position and walking. Among the complications dominated by superficial and deep infections, which involved 28 patients, of which required surgical intervention in 21 patients. Further re-operated due to disease progression were 23 patients. Marked increase in pain and progression of neurological deficits were observed in 9 patients. In the postoperative period 2 patients died. 14 patients had heavy bleeding during the operation. Implants destabilization involved 2 patients. Conclusions. Metastasis in the spine are mostly multifocal. Surgical treatment of metastases to the spine is a valuable method of treatment, clearly improves the quality of life of patients. Complications of surgery are common and due to the clearly increased risk of surgery in all patients with cancer.