Cancer वाले Spine Fracture का इलाज /Pathological spine fracture treatment

Dr Himanshu Tyagi, Senior consultant Spine & orthopedic surgeon.

Ph : 9654095717

MCh Orthopaedics (U.K), FNB Spine surgery, DNB Orthopaedics


Pathological spine fractures are the result of an underlying disease process that affects the spine. They are called vertebral compression fractures and are common, and frequent in the elderly. They may be caused by osteoporosis, Paget’s disease, other diseases and spinal infections (osteomyelitis). Frequently pathological spine fractures result from tumors that start in the spine or from metastatic cancer. 10-15% of cancers affect the spine.

Management of a pathological spine fracture will depend on whether the cause is benign or malignant. In addition to a complete medical history and physical exam, x-rays, MRI and CT scans can detect and evaluate pathological spine fractures.

Symptoms depend on the underlying disease or disorder. Symptoms of a pathological spine fracture may include: Pain in the back, legs and arms and neurological impairment.

Nonsurgical treatments are recommended for less severe pathological fractures. These include pain medications, bracing, and limiting physical activity. Surgery may be considered if the spine is unstable or where there is significant compression of the spinal cord and/or nerves.


Which metastatic cancers affect the spine?

Lymphoma

Multiple Myeloma

Breast

Prostate

Thyroid, and

Lung


Kyphoplasty Surgery

During kyphoplasty surgery, a small incision is made in the back through which the doctor places a narrow tube. Using fluoroscopy to guide it to the correct position, the tube creates a path through the back into the fractured area through the pedicle of the involved vertebrae.

Using X-ray images, the doctor inserts a special balloon through the tube and into the vertebrae, then gently and carefully inflates it. As the balloon inflates, it elevates the fracture, returning the pieces to a more normal position. It also compacts the soft inner bone to create a cavity inside the vertebrae.

The balloon is removed and the doctor uses specially designed instruments under low pressure to fill the cavity with a cement-like material called polymethylmethacrylate (PMMA). After being injected, the pasty material hardens quickly, stabilizing the bone.

Kyphoplasty surgery to treat a fracture from osteoporosis is performed at a hospital under local or general anesthesia.

Where Metastatic Spinal Tumors Occur

Spinal tumors can occur anywhere along the spine, but most occur in the thoracic (mid-to-upper back) region.

About 70% of metastatic spinal tumors occur in the thoracic region.

About 20% occur in the lumbar (lower back) region.

Fewer occur in the cervical (neck) region.

It is also possible for metastatic spinal tumors to occur in multiple regions of the spine at the same time. About 90% of diagnosed spinal tumors are metastatic spinal tumors.

Common signs of spinal cord cancer tumors and vertebral cancer tumors may include the following:

Back and/or neck pain

Arm and/or leg pain

Muscle weakness

Loss of sensation

Difficulty walking

Loss of bowel or bladder function

Spinal deformities (hunchback)

Paralysis

Pain or difficulty standing.

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• Category

  Pain Management in Cancer