Warning: mkdir(): Permission denied in /home/virtual/lib/view_data.php on line 81 Warning: fopen(/home/virtual/e-kjs/journal/upload/ip_log/ip_log_2024-04.txt): failed to open stream: No such file or directory in /home/virtual/lib/view_data.php on line 83 Warning: fwrite() expects parameter 1 to be resource, boolean given in /home/virtual/lib/view_data.php on line 84 Preliminary Efficacy of Combination Decompressive Surgery, Stabilization and Cyberknife Radiosurgery: A New Treatment Paradigm for Metastatic Spinal Tumors with Cord Invasion.
  • Advanced Search
Korean J Spine Search

CLOSE

Original Article
Korean J Spine 2011;8(3): 202-207.
10
DOI: https://doi.org/10.14245/kjs.2011.8.3.202   
Preliminary Efficacy of Combination Decompressive Surgery, Stabilization and Cyberknife Radiosurgery: A New Treatment Paradigm for Metastatic Spinal Tumors with Cord Invasion.
Do Keun Kim, Seung Hwan Yoon, Chang Hyun Oh, Hyung Chun Park, Chong Oon Park, Dong Keun Hyun
1Department of Neurosurgery, Inha University College of Medicine, Incheon, Korea. nsysh@inha.ac.kr
2Seoul Regional Military Manpower Administration, Seoul, Korea.
Abstract
OBJECTIVE
The goal of this retrospective study was to assess clinical and radiographic outcomes of posterior surgical decompression with stabilization followed by image-guided robot Cyberknife radiosurgery for encircling malignant tumors of the spine.
METHODS
From August 2008 to December 2009, 14 consecutive patients with a malignant spinal metastatic lesion with cord compression were treated at the author's institute. Patients underwent on a decompressive surgery by the posterior approach, and latent unstable spines were stabilized with instrumentation. After recovery, radiosurgery was administered at doses ranging from 16 to 26 Gy (mean 20.1Gy) prescribed to the 75-85% isodose line that encompassed at least 95% of tumor volumes. Visual Analogue Scale, American spine injury association grades, and MRI with gadolinium enhancement were used to monitor pain, neurology, and radiological outcomes, respectively, after the radiosurgery.
RESULTS
No acute radiation-induced toxicity or new neurological deficit occurred during the follow-up period (mean 4.5 months). Axial pain improved in 10 out of the 14 patients. No hardware failure was encountered. At 3-6 months after the Cyberknife radiosurgery, local control and effective therapeutic rates were both 80%(8/10) and no lesion enhancement on vertebral bodies or pedicles was visualized by MRI.
CONCLUSION
Posterior decompression with stabilization followed by radiosurgery of residual tumor in the anterolateral region is useful in cases where an anterior approach or a circumferential approach is not an option due to medical condition. Longer term follow-up is required to evaluate survival and late toxicities.
Keywords: Spinal metastasis;Cyberknife;Radiosurgery;Surgery
  • Medtronic
    • TOOLS
    Share :
    Facebook Twitter Linked In Google+
    METRICS Graph View
    • 0 Crossref
    •   Scopus
    • 3,785 View
    • 23 Download
    Related articles in NS

    Effectiveness of Surgical Decompression and Fixation in Patients with Metastatic Spinal Cord Compression2007 December;4(4)

    Journal Impact Factor 3.2
    ABOUT
    SUBSPECIALTY

    Browse all articles >

    ARTICLE CATEGORY

    Browse all articles >

    BROWSE ARTICLES
    AUTHOR INFORMATION
    Editorial Office
    CHA University, CHA School of Medicine Bundang Medical Center
    59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 13496, Korea
    Tel: +82-31-780-1924  Fax: +82-31-780-5269  E-mail: support@e-neurospine.org
    The Korean Spinal Neurosurgery Society
    #407, Dong-A Villate 2nd Town, 350 Seocho-daero, Seocho-gu, Seoul 06631, Korea
    Tel: +82-2-585-5455  Fax: +82-2-2-523-6812  E-mail: ksns1987@gmail.com
    Business License No.: 209-82-62443

    Copyright © The Korean Spinal Neurosurgery Society.

    Developed in M2PI

    Close layer
    prev next