Objective
To demonstrate optimal treatment strategy for thoracolumbar junction metastasis
Methods
Nine patients with thoracolumbar junction metastasis(12.3% of total spine metastasis) were surgically managed between January 1988 and December 2002. All patients except one had primary tumors showing moderate or rapid growth. Most patients presented with progressive motor weakness. In all cases decompression was performed via posterior approach. Posterior decompression without fixation was performed in 3 patients decompression with pedicle screw fixation was performed in 6 patients.
Results
Eight patients showed stationary or improved neurological status at immediate postoperative period. One patient expired due to hepatic failure immediately after operation. Postoperative mean survival was 3.9 months except one with Non-Hodgkins lymphoma who survived for 54 months. None of the patients underwent pedicle screw fixation demonstrated instrument failure.
Conclusion
Like spine metastasis of other location, prognosis seems to depend on the biological behavior of primary tumor. In primary tumors showing moderate and rapid growth, mere posterior decompression and fixation seems to be sufficient for thoracolumbar junction metastasis in terms of short-term stabilization. In primary tumors showing slow growth, however, more aggressive treatment using minimally invasive method might be considered.
