SPINAL-CORD DECOMPRESSION AND STABILIZATION IN MALIGNANT LESIONS OF THE SPINE

20 patients with neurologic deficit and pain from malignant spinal tum ors (7 primary) underwent 28 decompression and stabilization procedure s. Their mean age was 57 (30-74) years and 11 were women. Indications for stabilization were pathological spine fractures or a previous spin al decompression procedure. An anterior procedure was used in 2 patien ts with disease limited to 1 or 2 levels. A posterior procedure was us ed in 10 patients with widespread disease and unsatisfactory condition . Anteroposterior procedures in 1 or 2 stages were performed on 8 pati ents in satisfactory general condition with a malignant lesion at 1 or 2 levels and an unstable spine. Patients were submitted to radio- and /or chemotherapy postoperatively. Survival of patients treated for pri mary malignant tumors averaged 30 months and was 11 months for metasta tic disease. 16 of the patients, especially those with nonmetastatic d isease, had substantial relief of pain. Neurologic recovery was achiev ed in all of the anterior and combined anterior-posterior procedures a nd in 60% of the posterior decompressions. Complications included fail ure of the instrumentation in 2 cases, skirt breakdown in another 2 an d dislodgment of the autograft in 1.