Korean J Spine Search


Treatment of Thoracolumbar Junction Metastasis:Does Posterior Approach Suffice?
Dong Yeob Lee, M.D., Chun Kee Chung, M.D., Tae-Ahn Jahng, M.D. and Hyun Jib Kim, M.D.
Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
흉요추 이행부 전이성 척추종양의 치료: 후방접근법으로 충분한가?
서울대학교 의과대학 신경외과학교실
To demonstrate optimal treatment strategy for thoracolumbar junction metastasis
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.
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.
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.
Keywords: ThoracolumbarㆍMetastasis, Posterior approach

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