Abstract
There are a wide variety of disorders that can affect the subaxial cervical spine. Neoplasms are one such disorder: they may be either primary lesions or metastases and range from the histologically benign to the malignant. There has been significant increase of the knowledge and categorization/classification of these tumors and how they affect the spine. Several applicable treatment algorithms that can be tailored to each individual patient have been developed.
Treatment of neoplasms of the subaxial cervical spine often requires a multifaceted approach, incorporating the input of spinal surgeons, medical oncologists, and radiation oncologists, as well as other subspecialists such as plastic surgeons, neuro-interventionalists, and rehabilitation therapists. Ever-advancing image-guided radiotherapy techniques, as well as advances in chemotherapy treatments, are rapidly changing the manner in which these lesions are treated, limiting morbidity while maintaining the similar palliative effect of aggressive resection. Nonetheless, surgery still plays a significant role in the treatment of neoplastic disease of the subaxial cervical spine.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Smith GW, Robinson RA. The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg Am. 1958;40-A(3):607–24.
Cloward RB. The anterior approach for removal of ruptured cervical disks. J Neurosurg. 1958;15(6):602–17.
de Jonge T, Slullitel H, Dubousset J, Miladi L, Wicart P, Illés T. Late-onset spinal deformities in children treated by laminectomy and radiation therapy for malignant tumours. Eur Spine J. 2005;14(8):765–71.
Lonstein JE. Post-laminectomy kyphosis. Clin Orthop Relat Res. 1977;128:93–100.
O'Shaughnessy BA, Liu JC, Hsieh PC, Koski TR, Ganju A, Ondra SL. Surgical treatment of fixed cervical kyphosis with myelopathy. Spine. 2008;33(7):771–8.
Kriskovich MD, Apfelbaum RI, Haller JR. Vocal fold paralysis after anterior cervical spine surgery: incidence, mechanism, and prevention of injury. Laryngoscope. 2000;110(9):1467–73.
Shriver MF, Lewis DJ, Kshettry VR, Rosenbaum BP, Benzel EC, Mroz TE. Dysphagia rates after anterior cervical Diskectomy and fusion: a systematic review and meta-analysis. Global Spine J. 2017;7(1):95–103.
Pavlov H, Torg JS, Robie B, Jahre C. Cervical spinal stenosis: determination with vertebral body ratio method. Radiology. 1987;164(3):771–5.
Lim J-K, Wong H-K. Variation of the cervical spinal Torg ratio with gender and ethnicity. Spine J. 2004;4(4):396–401.
Cohen ZR, Fourney DR, Marco RA, Rhines LD, Gokaslan ZL. Total cervical spondylectomy for primary osteogenic sarcoma: case report and description of operative technique. JNS Spine. 2002;97:386–92.
Rades D, Fehlauer F, Stalpers LJA, Wildfang I, Zschenker O, Schild SE, et al. A prospective evaluation of two radiotherapy schedules with 10 versus 20 fractions for the treatment of metastatic spinal cord compression: final results of a multicenter study. Cancer. 2004;101(11):2687–92.
Rades D, Fehlauer F, Schulte R, Veninga T, Stalpers LJA, Basic H, et al. Prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression. J Clin Oncol. 2006;24(21):3388–93.
Rades D, Karstens JH, Alberti W. Role of radiotherapy in the treatment of motor dysfunction due to metastatic spinal cord compression: comparison of three different fractionation schedules. Int J Radiat Oncol Biol Phys. 2002;54(4):1160–4.
Gilbert RW, Kim JH, Posner JB. Epidural spinal cord compression from metastatic tumor: diagnosis and treatment. Ann Neurol. 1978;3(1):40–51.
Maranzano E, Latini P, Perrucci E, Beneventi S, Lupattelli M, Corgna E. Short-course radiotherapy (8 Gy x 2) in metastatic spinal cord compression: an effective and feasible treatment. Int J Radiat Oncol Biol Phys. 1997;38(5):1037–44.
Maranzano E, Bellavita R, Rossi R, De Angelis V, Frattegiani A, Bagnoli R, et al. Short-course versus split-course radiotherapy in metastatic spinal cord compression: results of a phase III, randomized, multicenter trial. J Clin Oncol. 2005;23(15):3358–65.
Katagiri H, Takahashi M, Inagaki J, Kobayashi H, Sugiura H, Yamamura S, et al. Clinical results of nonsurgical treatment for spinal metastases. Int J Radiat Oncol Biol Phys. 1998;42(5):1127–32.
Gerszten PC, Mendel E, Yamada Y. Radiotherapy and radiosurgery for metastatic spine disease: what are the options, indications, and outcomes? Spine. 2009;34(22 Suppl):S78–92.
Laufer I, Rubin DG, Lis E, Cox BW, Stubblefield MD, Yamada Y, et al. The NOMS framework: approach to the treatment of spinal metastatic tumors. Oncologist. 2013;18(6):744–51.
Laufer I, Iorgulescu JB, Chapman T, Lis E, Shi W, Zhang Z, et al. Local disease control for spinal metastases following “separation surgery” and adjuvant hypofractionated or high-dose single-fraction stereotactic radiosurgery: outcome analysis in 186 patients. J Neurosurg Spine. 2013;18(3):207–14.
Lovelock DM, Zhang Z, Jackson A, Keam J, Bekelman J, Bilsky M, et al. Correlation of local failure with measures of dose insufficiency in the high-dose single-fraction treatment of bony metastases. Int J Radiat Oncol Biol Phys. 2010;77(4):1282–7.
Bilsky MH, Laufer I, Burch S. Shifting paradigms in the treatment of metastatic spine disease. Spine. 2009;34(22 Suppl):S101–7.
Fisher CG, DiPaola CP, Ryken TC, Bilsky MH, Shaffrey CI, Berven SH, et al. A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group. Spine. 2010;35(22):E1221–9.
Bilsky MH, Laufer I, Fourney DR, Groff M, Schmidt MH, Varga PP, et al. Reliability analysis of the epidural spinal cord compression scale. J Neurosurg Spine. 2010;13(3):324–8.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Rymarczuk, G.N., Pendleton, C., Harrop, J.S. (2019). Anterior Subaxial Cervical Approach. In: Sciubba, D. (eds) Spinal Tumor Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-98422-3_5
Download citation
DOI: https://doi.org/10.1007/978-3-319-98422-3_5
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-98421-6
Online ISBN: 978-3-319-98422-3
eBook Packages: MedicineMedicine (R0)