Posterior segmental spinal instrumentation (PSSI) with posterolateral decompression and debulking for metastatic thoracic and lumbar spine disease: Limitations of the technique

Keith H. Bridwell, Arthur B. Jenny, Thomas Saul, Keith M. Rich, Robert L. Grubb

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97 Scopus citations

Abstract

Twenty-five patients with metastatic thoracic and lumbar spine disease were initially treated by the authors with posterolateral debridement and decompression, along with posterior segmental spinal instrumentation. Ten patients had marked paresis, nine had signs of spinal cord or cauda equina compression without paresis, and all patients had pain severe enough to prevent sitting/standing/walking. The posterior approach was used in these patients instead of an anterior one because of translocatlon (4), three-column disease (16), three or more vertebral bodies involved (13), disease at two separate locations (2), and inability to tolerate an anterior approach (3). All patients had maintenance of spinal alignment for the length of follow-up or until their ultimate demise. Good pain relief was achieved in 19 of 25 patients. Six of ten patients with significant paresis recovered. Four patients developed recurrent spinal cord compression within 12 months postoperative from regrowth of tumor that was not controlled by radiotherapy or chemotherapy. Six of the 25 patients were not significantly palliated by the technique.

Original languageEnglish
Pages (from-to)1383-1394
Number of pages12
JournalSpine
Volume13
Issue number12
DOIs
StatePublished - Dec 1988

Keywords

  • Palliation
  • Paresis
  • Posterior segmental spinal instrumentation
  • Posterolateral debridement/decompression
  • Spinal alignment

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