Abstract
We report six cases of metastasic spinal tumor who were operated by Luque SSI (segmental spinal instrumentation) with bone cement fixation. There were five males and one female with a mean age of 64.3 years (range 59-71 years). There were two cases of prostate cancer, and one each of lung cancer, thyroid cancer, malignant lymphoma and of unknown cause. There was major metastasis in Th3 in two cases, and in Th2, Th4, Th7 and Th8, respectively, in each of the remaining four cases. All patients had paraplegia (Frankel grade C in four cases and B in two cases). We operated by posterior decompression and instrumentation (Luque SSI) in all cases. In four cases, anterior decompression from posterolateral approach by using CUSA was done. The range of fixation was set at above and below two or three levels from decompression area in all cases. Lower cervical fixation was performed in four cases. Postoperatively, radiation therapy was tried for all cases. The mean follow up period was 14 months (range 5-31 months). Five cases recovered on Frankel grading scale, four cases showed good result on pain grading scale and five cases showed recovery on ADL grading scale. Although, there was one minor instrumentation failure such as cutting of sublaminal wiring, stability of fixation site was maintained until final follow up in all cases. This study shows that the Luque SSI with bone cement fixation is a good method for management of metastatic spinal tumors, especially for fixation of cervical spine in cases with upper thoracic spinal metastasis, because it is difficult to use the hook and screw systems in such cases.
