PRIMARY BONE-TUMORS OF THE SPINE - A SURVEY OF THE EVALUATION AND TREATMENT AT THE ISTITUTO-ORTOPEDICO-RIZZOLI

The experience at Istituto Rizzoli with 366 primary bone tumors of the spine focuses on the criteria for planning and treatment. An accurate preoperative evaluation by standard radiograph, computerized tomograp hy scan, and magnetic resonance imaging allow the classification of be nign lesions as latent (not requiring treatment), active (curettage), or aggressive (curettage plus adjuvants or marginal resection), The ma lignant lesions are classified as intracompartmental or extracompartme ntal (both low and high grade), Wide resection is attempted, but seldo m is feasible, An angiographic study of the spinal cord is compulsory for lesions located in the thoracolumbar region, The value of emboliza tion is enhanced, primarily in highly vascular lesions, An accurate pr eoperative study of the vital parameters of the patient, together with a continuous intraoperative monitoring, is mandatory.