Skip to main content
SpringerLink
Log in

Complications of Surgical and Medical Care

Anticipation and Management

  • Chapter
Cancer in the Spine

Part of the book series: Current Clinical Oncology ((CCO))

  • 1122 Accesses

Abstract

Complications related to the treatment of spinal neoplasms are often associated with inaccurate pre-operative assessment and diagnosis, as well as the definitive surgical procedure. A careful history and physical examination can lead to the appropriate diagnosis (1) and identify co-existing premorbid conditions, which may require further evaluation before operative intervention. Appropriate radiological and laboratory studies are important because they may lead to the correct diagnosis and direct proper treatment (2). In general, once a lesion is identified, a biopsy should be obtained to make a definitive diagnosis. Exact techniques of the biopsy and the definitive treatment should be tailored to the nature and location of the lesion and the patient’s general condition and life expectancy. A multidisciplinary team approach consisting of surgical, medical, and radiation oncologists, combined with experienced radiologists and pathologists, helps optimize patient care. The goals of operative intervention of spinal tumors are pain control, maintenance, or improvement of neurological function, eradication of the tumor, and maintenance of spinal stability, and the attainment of normal coronal and sagittal alignment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Rougraff BT, Kneisl JS, Simon MA. Skeletal metastases of unknown origin. A prospective study of a diagnostic strategy. J Bone Joint Surg Am 1993; 75:1276–1281.

    PubMed  CAS  Google Scholar 

  2. Simon MA, Finn HA. Diagnostic strategy for bone and soft-tissue tumors. J Bone Joint Surg Am 1993; 75:622–631.

    PubMed  CAS  Google Scholar 

  3. Simeon FA, Lawner PM. Intraspinal neoplasms. In: Rothman RH, Simeon FA, eds. The Spine. Philadelphia, PA: W.B. Saunders; 1982:1041–1054.

    Google Scholar 

  4. Gruszkiewicz J, Doron Y, Borovich B, Zaaroor M. Spinal cord compression in Paget’s disease of bone with reference to sarcomatous degeneration and calcitonin treatment. Surg Neurol 1987; 27:117–125.

    Article  PubMed  CAS  Google Scholar 

  5. Eismont FJ, Green BA, Brown MD, Ghandur-Mnaymneh L. Coexistent infection and tumor of the spine. A report of three cases. J Bone Joint Surg Am 1987; 69:452–458.

    PubMed  CAS  Google Scholar 

  6. Benassi MS, Ragazzini P, Gamberi G, et al. Adhesion molecules in high-grade soft tissue sarcomas: correlation to clinical outcome. Eur J Cancer 1998; 34:496–502.

    Article  PubMed  CAS  Google Scholar 

  7. An HS, Vaccaro AR, Dolinskas CA, Cotler JM, Balderston RA, Bauerle WB. Differentiation between spinal tumors and infections with magnetic resonance imaging. Spine 1991; 16:S334–S338.

    Article  PubMed  CAS  Google Scholar 

  8. An HS, Andreshak TG, Nguyen C, Williams A, Daniels D. Can we distinguish between benign versus malignant compression fractures of the spine by magnetic resonance imaging? Spine 1995; 20:1776–1782.

    PubMed  CAS  Google Scholar 

  9. Bilsky MH, Boland P, Lis E, Raizer JJ, Healey JH. Single-stage posterolateral transpedicle approach for spondylectomy, epidural decompression, and circumferential fusion of spinal metastases. Spine 2000; 25:2240–2249.

    Article  PubMed  CAS  Google Scholar 

  10. Graham JJ, Yang WC. Vertebral hemangioma with compression fracture and paraparesis treated with preoperative embolization and vertebral resection. Spine 1984; 9:97–101.

    Article  PubMed  CAS  Google Scholar 

  11. Hekster RE, Luyendijk W, Tan TI. Spinal-cord compression caused by vertebral haemangioma relieved by percutaneous catheter embolisation. Neuroradiology 1972; 3:160–164.

    Article  PubMed  CAS  Google Scholar 

  12. Roscoe MW, McBroom RJ, St Louis E, Grossman H, Perrin R. Preoperative embolization in the treatment of osseous metastases from renal cell carcinoma. Clin Orthop Relat Res 1989; 238:302–307.

    PubMed  Google Scholar 

  13. Simon MA, Biermann JS. Biopsy of bone and soft-tissue lesions. J Bone Joint Surg Am 1993; 75:616–621.

    PubMed  CAS  Google Scholar 

  14. Ayala AG, Raymond AK, Ro JY, Carrasco CH, Fanning CV, Murray JA. Needle biopsy of primary bone lesions. M.D. Anderson experience. Pathol Annu 1989; 24:219–251.

    PubMed  Google Scholar 

  15. Mick CA, Zinreich J. Percutaneous trephine bone biopsy of the thoracic spine. Spine 1985; 10:737–740.

    Article  PubMed  CAS  Google Scholar 

  16. Alexander AH. Chymopapain chemonucleolysis, discography, and needle biopsy technique. In: Chapman MW, ed. Operative Orthopaedics. Philadelphia,PA: J.B. Lippincott; 1988:2125–2135.

    Google Scholar 

  17. Bender CE, Berquist TH, Wold LE. Imaging-assisted percutaneous biopsy of the thoracic spine. Mayo Clin Proc 1986; 61:942–950.

    PubMed  CAS  Google Scholar 

  18. Fyfe IS, Henry AP, Mulholland RC. Closed vertebral biopsy. J Bone Joint Surg Br 1983; 65:140–143.

    PubMed  CAS  Google Scholar 

  19. Laredo JD, Bard M. Thoracic spine: percutaneous trephine biopsy. Radiology 1986; 160:485–489.

    PubMed  CAS  Google Scholar 

  20. Ottolenghi CE, Shajowicz F, DeSchant FA. Aspiration biopsy of the cervical spine. Techniques and results in twenty-four cases. J Bone Joint Surg Am 1964; 46A:715–733.

    Google Scholar 

  21. Ambrose GB, Alpert M, Neer CS. Vertebral osteomyelitis. A diagnostic problem. JAMA 1966; 197:619–622.

    Article  PubMed  CAS  Google Scholar 

  22. Armstrong P, Chalmers AH, Green G, Irving JD. Needle aspiration/biopsy of the spine in suspected disc infection. Br J Radiol 1978; 51:333–337.

    Article  PubMed  CAS  Google Scholar 

  23. Debnam JW, Staple TW. Needle biopsy of bone. Radiol Clin North Am 1975; 13:157–164.

    PubMed  CAS  Google Scholar 

  24. Gladstein MO, Grantham SA. Closed skeletal biopsy. Clin Orthop Relat Res 1974; 0:75–79.

    Article  CAS  Google Scholar 

  25. McLaughlin RE, Miller WR, Miller CW. Quadriparesis after needle aspiration of the cervical spine. Report of a case. J Bone Joint Surg Am 1976; 58:1167–1168.

    PubMed  CAS  Google Scholar 

  26. McLain RF. Spinal cord decompression: an endoscopically assisted approach metastatic tumors. Spinal Cord 2001; 39:482–487.

    Article  PubMed  CAS  Google Scholar 

  27. Tomita K, Kawahara N, Kobayashi T, Yoshida A, Murakami H, Akamaru T. Surgical strategy for spinal metastases. Spine 2001; 26:298–306.

    Article  PubMed  CAS  Google Scholar 

  28. Boriani S, Biagini R, De Iure F, et al. En bloc resections of bone tumors of the thoracolumbar spine. A preliminary report on 29 patients. Spine 1996; 21:1927–1931.

    Article  PubMed  CAS  Google Scholar 

  29. Tomita K, Kawahara N, Baba H, Tsuchiya H, Fujita T, Toribatake Y. Total en bloc spondylectomy. A new surgical technique for primary malignant vertebral tumors. Spine 1997; 22:324–333.

    Article  PubMed  CAS  Google Scholar 

  30. Mankin HJ, Lange TA, Spanier SS. The hazards of biopsy in patients with malignant primary bone and soft-tissue tumors. J Bone Joint Surg Am 1982; 64:1121–1127.

    PubMed  CAS  Google Scholar 

  31. Mankin HJ, Mankin CJ, Simon MA. The hazards of the biopsy, revisited. Members of the Musculoskeletal Tumor Society. J Bone Joint Surg Am 1996; 78:656–663.

    PubMed  CAS  Google Scholar 

  32. Ebraheim NA, Inzerillo C, Xu R. Are anatomic landmarks reliable in determination of fusion level in posterolateral lumbar fusion? Spine 1999; 24:973–974.

    Article  PubMed  CAS  Google Scholar 

  33. Flynn TB. Neurologic complications of anterior cervical interbody fusion. Spine 1982; 7:536–539.

    Article  PubMed  CAS  Google Scholar 

  34. Cain JE Jr, Dryer RF, Barton BR. Evaluation of dural closure techniques. Suture methods, fibrin adhesive sealant, and cyanoacrylate polymer. Spine 1988; 13:720–725.

    Article  PubMed  Google Scholar 

  35. Eismont FJ, Wiesel SW, Rothman RH. Treatment of dural tears associated with spinal surgery. J Bone Joint Surg Am 1981; 63:1132–1136.

    PubMed  CAS  Google Scholar 

  36. Wang JC, Bohlman HH, Riew KD. Dural tears secondary to operations on the lumbar spine. Management and results after a two-yearminimum follow-up of eighty-eight patients. J Bone Joint Surg Am 1998; 80:1728–1732.

    Article  PubMed  CAS  Google Scholar 

  37. Heller JG, Kim HS, Carlson GW. Subarachnoid—pleural fistulae#x2014;management with a transdiaphragmatic pedicled greater omental flap: report of two cases. Spine 2001; 26:1809–1813.

    Article  PubMed  CAS  Google Scholar 

  38. Yerby SA, Ehteshami J. R.; and McLain, R. F.: Offset laminar hooks decrease bending moments of pedicle screws during in situ contouring. Spine, 22(4):376–81, 1997.

    Article  PubMed  CAS  Google Scholar 

  39. Boland PJ, Lane JM, Sundaresan N. Metastatic disease of the spine. Clin Orthop Relat Res 1982; 169:95–102.

    PubMed  Google Scholar 

  40. Gokaslan ZL, York JE, Walsh GL, et al. Transthoracic vertebrectomy for metastatic spinal tumors. J Neurosurg 1998; 89:599–609.

    PubMed  CAS  Google Scholar 

  41. Harrington KD. The use of methylmethacrylate for vertebral-body replacement and anterior stabilization of pathological fracture-dislocations of the spine due to metastatic malignant disease. J Bone Joint Surg Am 1981; 63:36–46.

    PubMed  CAS  Google Scholar 

  42. McAfee PC, Bohlman HH, Ducker T, Eismont FJ. Failure of stabilization of the spine with methylmethacrylate. A retrospective analysis of twenty-four cases. J Bone Joint Surg Am 1986; 68:1145–1157.

    PubMed  CAS  Google Scholar 

  43. Talmi YP, Knoller N, Dolev M, et al. Postsurgical prevertebral abscess of the cervical spine. Laryngoscope 2000; 110:1137–1141.

    Article  PubMed  CAS  Google Scholar 

  44. Cleveland RH, Gilsanz V, Lebowitz RL, Wilkinson RH. Hydronephrosis from retroperitoneal fibrosis after anterior spine fusion. A case report. J Bone Joint Surg Am 1978; 60:996–997.

    PubMed  CAS  Google Scholar 

  45. Isiklar ZU, Lindsey RW, Coburn M. Ureteral injury after anterior lumbar interbody fusion. A case report. Spine 1996; 21:2379–2382.

    Article  PubMed  CAS  Google Scholar 

  46. Johnson RM, McGuire EJ. Urogenital complications of anterior approaches to the lumbar spine. Clin Orthop 1981; 81:114–8.

    Google Scholar 

  47. Nygaard IE, Kreder KJ. Spine update. Urological management in patients with spinal cord injuries. Spine 1996; 21:128–132.

    Article  PubMed  CAS  Google Scholar 

  48. Silber I, McMaster W. Retroperitoneal fibrosis with hydronephrosis as a complication of the Dwyer procedure. J Pediatr Surg 1977; 12:255–257.

    Article  PubMed  CAS  Google Scholar 

  49. Shen YS, Cheung CY, Nilsen PT. Chylous leakage after arthrodesis using the anterior approach to the spine. Report of two cases. J Bone Joint Surg Am 1989; 71:1250–1251.

    PubMed  CAS  Google Scholar 

  50. U, HS, Wilson CB. Postoperative epidural hematoma as a complication of anterior cervical discectomy. Report of three cases. J Neurosurg 1978; 49:288–291.

    Article  PubMed  CAS  Google Scholar 

  51. Epstein NE, Hollingsworth R, Nardi D, Singer J. Can airway complications following multilevel anterior cervical surgery be avoided? J Neurosurg 2001; 94:185–188.

    PubMed  CAS  Google Scholar 

  52. Bulger RF, Rejowski JE, Beatty RA. Vocal cord paralysis associated with anterior cervical fusion: considerations for prevention and treatment. J Neurosurg 1986; 62:657–661.

    Google Scholar 

  53. Heeneman H. Vocal cord paralysis following approaches to the anterior cervical spine. Laryngoscope 1973; 83:17–21.

    Article  PubMed  CAS  Google Scholar 

  54. Heary RF, Albert TJ, Ludwig SC, et al. Surgical anatomy of the vertebral arteries. Spine 1996; 21:2074–2080.

    Article  PubMed  CAS  Google Scholar 

  55. Smith MD, Emery SE, Dudley A, Murray KJ, Leventhal M. Vertebral artery injury during anterior decompression of the cervical spine. A retrospective review of ten patients. J Bone Joint Surg Br 1993; 75:410–415.

    PubMed  CAS  Google Scholar 

  56. Ebraheim NA, An HS, Xu R, Ahmad M, Yeasting RA. The quantitative anatomy of the cervical nerve root groove and the intervertebral foramen. Spine 1996; 21:1619–1623.

    Article  PubMed  CAS  Google Scholar 

  57. An HS, Gordin R, Renner K. Anatomic considerations for platescrew fixation of the cervical spine. Spine 1991; 16:S548–S551.

    Article  PubMed  CAS  Google Scholar 

  58. Ebraheim NA, Xu R, Ahmad M, Heck B. The quantitative anatomy of the vertebral artery groove of the atlas and its relation to the posterior atlantoaxial approach. Spine 1998; 23:320–333.

    Article  PubMed  CAS  Google Scholar 

  59. An HS, Vaccaro A, Cotler JM, Lin S. Spinal disorders at the cervicothoracic junction. Spine 1994; 19:2557–2564.

    PubMed  CAS  Google Scholar 

  60. Sundaresan N, Shah J, Foley KM, Rosen G. An anterior surgical approach to the upper thoracic vertebrae. J Neurosurg 1984; 61:686–690.

    PubMed  CAS  Google Scholar 

  61. Baker JK, Reardon PR, Reardon MJ, Heggeness MH. Vascular injury in anterior lumbar surgery. Spine 1993; 18:2227–2230.

    Article  PubMed  CAS  Google Scholar 

  62. Lu J, Ebraheim NA, Biyani A, Brown JA, Yeasting RA. Vulnerability of great medullary artery. Spine 1996; 21:1852–1855.

    Article  PubMed  CAS  Google Scholar 

  63. Wise JJ, Fischgrund JS, Herkowitz HN, Montgomery D, Kurz LT. Complication, survival rates, and risk factors of surgery for metastatic disease of the spine. Spine 1999; 24:1943–1951.

    Article  PubMed  CAS  Google Scholar 

  64. Harbison SP. Major vascular complications of intervertebral disc surgery. Ann Surg 1954; 140:342–348.

    Article  PubMed  CAS  Google Scholar 

  65. Kawahara N, Tomita K, Baba H, et al. Cadaveric vascular anatomy for total en bloc spondylectomy in malignant vertebral tumors. Spine 1996; 21:1401–1407.

    Article  PubMed  CAS  Google Scholar 

  66. Stener B. Complete removal of vertebrae for extirpation of tumors. A 20-year experience. Clin Orthop Relat Res 1989; 245:72–82.

    PubMed  Google Scholar 

  67. Dwyer AP. A fatal complication of paravertebral infection and traumatic aneurysm following Dwyer instrumentation. J Bone Joint Surg 1979; 61B:239.

    Google Scholar 

  68. Colletta AJ, Mayer PJ. Chylothorax: an unusual complication of anterior thoracic interbody spinal fusion. Spine 1982; 7:46–49.

    Article  PubMed  CAS  Google Scholar 

  69. Eisenstein S, O’Brien JP. Chylothorax: a complication of Dwyer’s anterior instrumentation. Br J Surg 1977; 64:339–341.

    Article  PubMed  CAS  Google Scholar 

  70. Shen YS, Cheung CY, Nilsen PT. Chylous leakage after arthrodesis using the anterior approach to the spine. Report of two cases. J Bone Joint Surg Am 1989; 71:1250–1251.

    PubMed  CAS  Google Scholar 

  71. Catre MG. Anticoagulation in spinal surgery. A critical review of the literature. Can J Surg 1997; 40:413–419.

    PubMed  CAS  Google Scholar 

  72. Dearborn JT, Hu SS, Tribus CB, Bradford DS. Thromboembolic complications after major thoracolumbar spine surgery. Spine 1999; 24:1471–1476.

    Article  PubMed  CAS  Google Scholar 

  73. Lee HM, Suk KS, Moon SH, Kim DJ, Wang JM, Kim NH. Deep vein thrombosis after major spinal surgery: incidence in an East Asian population. Spine 2000; 25:1827–1830.

    Article  PubMed  CAS  Google Scholar 

  74. Cain JE, Major MR, Lauerman WC, West JL, Wood KB, Fueredi GA. The morbidity of heparin therapy after development of pulmonary embolus in patients undergoing thoracolumbar or lumbar spinal fusion. Spine 1995; 20:1600–1603.

    Article  PubMed  Google Scholar 

  75. Weinstein MA, McCabe JP, Cammisa FP Jr. Postoperative spinal wound infection: a review of 2,391 consecutive index procedures. J Spinal Disord 2000; 13:422–426.

    Article  PubMed  CAS  Google Scholar 

  76. Klekamp J, Spengler DM, McNamara MJ, Haas DW. Risk factors associated with methicillin-resistant staphylococcal wound infection after spinal surgery. J Spinal Disord 1999; 12:187–191.

    PubMed  CAS  Google Scholar 

  77. Lonstein J, Winter R, Moe J, Gaines D. Wound infection with Harrington instrumentation and spine fusion for scoliosis. Clin Orthop Relat Res 1973; 96:222–233.

    Article  PubMed  Google Scholar 

  78. Ghogawala Z, Mansfield FL, Borges LF. Spinal radiation before surgical decompression adversely affects outcomes of surgery for symptomatic metastatic spinal cord compression. Spine 2001; 26:818–824.

    Article  PubMed  CAS  Google Scholar 

  79. McPhee IB, Williams RP, Swanson CE. Factors influencing wound healing after surgery for metastatic disease of the spine. Spine 1998:23:726–732.

    Article  PubMed  CAS  Google Scholar 

  80. Pascal-Moussellard H, Broc G, Pointillart V, Simeon F, Vital JM, Senegas J. Complications of vertebral metastasis surgery. Eur Spine J 1998; 7:438–444.

    Article  PubMed  CAS  Google Scholar 

  81. Dick J, Boachie-Adjei O, Wilson M. One-stage versus two-stage anterior and posterior spinal reconstruction in adults. Comparison of outcomes including nutritional status, complications rates, hospital costs, and other factors. Spine 1992; 17:S310–S316.

    Article  PubMed  CAS  Google Scholar 

  82. Seltzer MH, Bastidas JA, Cooper DM, Engler P, Slocum B, Fletcher HS. Instant nutritional assessment. JPEN J Parenter Enteral Nutr 1979; 3:157–159.

    Article  PubMed  CAS  Google Scholar 

  83. Hochberg J, Ardenghy M, Yuen J, et al. Muscle and musculocutaneous flap coverage of exposed spinal fusion devices. Plast Reconstr Surg 1998; 102:385–389.

    Article  PubMed  CAS  Google Scholar 

  84. Sorensen S, Helweg-Larsen S, Mouridsen H, Hansen HH. Effect of high-dose dexamethasone in carcinomatous metastatic spinal cord compression treated with radiotherapy: a randomised trial. Eur J Cancer 1994; 30A:22–27.

    Article  PubMed  CAS  Google Scholar 

  85. Vecht CJ, Haaxma-Reiche H, van Putten WL, de Visser M, Vries EP, Twijnstra A. Initial bolus of conventional versus high-dose dexamethasone in metastatic spinal cord compression. Neurology 1989; 39:1255–1257.

    PubMed  CAS  Google Scholar 

  86. Delattre JY, Arbit E, Rosenblum MK, et al. High dose versus low dose dexamethasone in experimental epidural spinal cord compression. Neurosurgery 1988; 22:1005–1007.

    Article  PubMed  CAS  Google Scholar 

  87. Heimdal K, Hirschberg H, Slettebo H, Watne K, Nome O. High incidence of serious side effects of high-dose dexamethasone treatment in patients with epidural spinal cord compression. J Neurooncol 1992; 12:141–144.

    Article  PubMed  CAS  Google Scholar 

  88. DePriest JL. Stress ulcer prophylaxis. Do critically ill patients need it?. Postgrad Med 1995; 98:159–161.

    PubMed  CAS  Google Scholar 

  89. Ellershaw JE, Kelly MJ. Corticosteroids and peptic ulceration. Palliat Med 1994; 8:313–319.

    Article  PubMed  CAS  Google Scholar 

  90. Goggans FC, Weisberg LJ, Koran LM. Lithium prophylaxis of prednisone psychosis: a case report. J Clin Psychol 1983; 44:111–112.

    CAS  Google Scholar 

  91. Slivka A, Wen PY, Shea WM, Loeffler JS. Pneumocystis carinii pneumonia during steroid taper in patients with primary brain tumors. Am J Med 1993; 94:216–219.

    Article  PubMed  CAS  Google Scholar 

  92. Akeyson EW, McCutcheon IE. Single-stage posterior vertebrectomy and replacement combined with posterior instrumentation for spinal metastasis. J Neurosurg 1996; 85:211–220.

    PubMed  CAS  Google Scholar 

  93. Magerl F, Coscia MF. Total posterior vertebrectomy of the thoracic or lumbar spine. Clin Orthop Relat Res 1988; 232:62–69.

    PubMed  Google Scholar 

  94. Bauer HC. Posterior decompression and stabilization for spinal metastases. Analysis of sixty-seven consecutive patients. J Bone Joint Surg Am 1997; 79:514–522.

    PubMed  CAS  Google Scholar 

  95. Siegal T, Tiqva P. Vertebral body resection for epidural compression by malignant tumors. Results of forty-seven consecutive operative procedures. J Bone Joint Surg Am 1985; 67:375–3825.

    PubMed  CAS  Google Scholar 

  96. Fraser RD, Paterson DC, Simpson DA.: Orthopaedic aspects of spinal tumors in children. J Bone Joint Surg Br 1977; 59:143–151.

    PubMed  CAS  Google Scholar 

  97. Otsuka NY, Hey L, Hall JE. Postlaminectomy and postirradiation kyphosis in children and adolescents. Clin Orthop Relat Res 1998; 354:189–194.

    Article  PubMed  Google Scholar 

  98. Yasuoka S, Peterson HA, MacCarty CS. Incidence of spinal column deformity after multilevel laminectomy in children and adults. J Neurosurg 1982; 57:441–445.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery and Department of Neurosurgery, University of Texas Medical School, Houston, TX

    Rex A. W. Marco MD

  2. Department of Orthopaedic Surgery, Rush-Presbyterian-St.Luke’s Medical Center, Chicago, IL

    Howard S. An MD

Authors
  1. Rex A. W. Marco MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Howard S. An MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Lerner College of Medicine and The Cleveland Clinic Spine Institute Department of Orthopaedic Surgery, The Cleveland Clinic Foundation, Cleveland, OH

    Robert F. McLain MD

  2. The Cleveland Clinic Spine Institute, The Cleveland Clinic Foundation, Cleveland, OH

    Kai-Uwe Lewandrowski MD  & Edward C. Benzel MD, FACS  & 

  3. University of Texas M. D. Anderson Cancer Center, Houston, TX

    Maurie Markman MD

  4. Taussig Cancer Center, The Cleveland Clinic Foundation, Cleveland, OH

    Ronald M. Bukowski MD

  5. Department of Radiation Oncology, The Cleveland Clinic Foundation, Cleveland, OH

    Roger Macklis MD

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Humana Press, Inc., Totowa, NJ

About this chapter

Cite this chapter

Marco, R.A.W., An, H.S. (2006). Complications of Surgical and Medical Care. In: McLain, R.F., Lewandrowski, KU., Markman, M., Bukowski, R.M., Macklis, R., Benzel, E.C. (eds) Cancer in the Spine. Current Clinical Oncology. Humana Press. https://doi.org/10.1007/978-1-59259-971-4_38

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-971-4_38

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-074-8

  • Online ISBN: 978-1-59259-971-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation