Prosthetic Replacement Surgery for Spine Metastasis
In the early 1970s, we began to find an increasing number of patients with metastatic disease of the spine, primarily cervical, presenting with constant pain. Subsequently neural deficits associated with vertebral collapse occurred and there was, according to professionals in the field, “nothing to do with them” or because “they don’t have long to go.” When we looked more carefully at these patients, it became obvious that they had all gathered together in one group and were generally treated in one or two ways; either only supportive care was provided or they were subjected to radio-therapy and/or laminectomy. Under more careful scrutiny, it became apparent that this was not a homogenous group. There were differences in these patients based on the primary tumor, location and number of metastatic sites, their general conditions, and, considering these factors, their long-term prognoses. We began to select those patients with a reasonable remaining life span of over 6 months who have pain due to instability and/or neural compression from vertebral collapse and carried out instrument replacement supplemented by methyl-methacrylate posteriorly and, in some instances, methyl-methacrylate replacement of vertebral bodies anteriorly. We were pleased with the pain relief and return of neural function achieved in these patients. Through similar experiences in subsequent years, we developed a metal prosthesis for replacement of the metastatic tumor-affected vertebra  (Fig. 1).
KeywordsVertebral Body Bone Cement Spine Metastasis Vertebral Collapse Prosthetic Replacement
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