Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
World Journal of Surgical Oncology
Published in: World Journal of Surgical Oncology 1/2017

Open Access 01-12-2017 | Research

Surgical treatment of upper cervical spine metastases: a retrospective study of 39 cases

Authors: Jian Yang, Qi Jia, Dongyu Peng, Wei Wan, Nanzhe Zhong, Yan Lou, Xiaopan Cai, Zhipeng Wu, Chenglong Zhao, Xinghai Yang, Jianru Xiao

Published in: World Journal of Surgical Oncology | Issue 1/2017

Login to get access

Abstract

Background

The surgical treatment of upper cervical spine metastases are controversial up to now. By summarizing and analyzing the clinical data of the upper cervical spine involved metastases treated surgically in our center, we mainly aimed to investigate the surgical decisions and outcomes so as to provide more references for the clinical treatment of this special and complex spine metastasis.

Methods

We evaluated the patients’ pre- and post-operative neck pain and neurologic function with paired t test, followed by the statistics of the selection of surgical approaches, ways of reconstruction, and related complications. Moreover, the Kaplan–Meier survival analysis was adopted to analyze the patients’ survival according to different growth group (rapid, moderate, and slow).

Results

There were 39 patients with atlantoaxial metastases in this study. The most common symptom (94.87%) was occipital-cervical pain, which relieved greatly after surgical interventions (p < 0.01). The metastases mainly resulted from lung cancer and nasopharyngeal cancer with an incidence of 38.46 and 10.26%, respectively. As to different growth group, the rapid-growth tumors accounted for 69.23% in all atlantoaxial metastases. Tumor resection and stabilization were performed mainly via the combined anterior and posterior approach (66.67%). The 1-, 2-, and 3-year overall survival rate at the last follow-up was 58.5, 40, and 28.3%, respectively, with a median survival time of 18 months. The rate of complications associated with the surgical intervention was 12.82% (5/39), which is lower than that of the previous reports and generally controllable.

Conclusions

Relatively radical interventions with surgery for upper cervical spine metastases offered satisfactory outcomes with a low mortality. Together with adjuvant therapy, surgical treatment benefits patients with atlantoaxial metastases by relieving regional pain, restoring or improving the neurologic function, stabilizing the quality of life, and prolonging the survival time of such patients.
Literature
1.
Quan GM, Vital JM, Pointillart V. Outcomes of palliative surgery in metastatic disease of the cervical and cervicothoracic spine. J Neurosurg Spine. 2011;14:612–8.CrossRefPubMed
2.
Sciubba DM, Gokaslan ZL. Are patients satisfied after surgery for metastatic spine disease? Spine J. 2010;10:63–5.CrossRefPubMed
3.
Sherk HH. Lesions of the atlas and axis. Clin Orthop Relat Res. 1975;109:33–41.
4.
Jonsson B, Jonsson Jr H, Karlstrom G, Sjostrom L. Surgery of cervical spine metastases: a retrospective study. Eur Spine J. 1994;3:76–83.CrossRefPubMed
5.
Kirchner R, Himpe B, Schweder B, Jurgens C, Gille JJ, Faschingbauer M. The clinical outcome after occipitocervical fusion due to metastases of the upper cervical spine: a consecutive case series and a systematic review of the literature. Z Orthop Unfall. 2014;152:358–65.CrossRefPubMed
6.
Atanasiu JP, Badatcheff F, Pidhorz L. Metastatic lesions of the cervical spine. a retrospective analysis of 20 cases. Spine (Phila Pa 1976). 1993;18:1279–84.CrossRef
7.
Phillips E, Levine AM. Metastatic lesions of the upper cervical spine. Spine (Phila Pa 1976). 1989;14:1071–7.CrossRef
8.
Nakamura M, Toyama Y, Suzuki N, Fujimura Y. Metastases to the upper cervical spine. J Spinal Disord. 1996;9:195–201.PubMed
9.
Sundaresan N, Galicich JH, Lane JM, Greenberg HS. Treatment of odontoid fractures in cancer patients. J Neurosurg. 1981;54:187–92.CrossRefPubMed
10.
Fourney DR, York JE, Cohen ZR, Suki D, Rhines LD, Gokaslan ZL. Management of atlantoaxial metastases with posterior occipitocervical stabilization. J Neurosurg. 2003;98:165–70.CrossRefPubMed
11.
Bilsky MH, Shannon FJ, Sheppard S, Prabhu V, Boland PJ. Diagnosis and management of a metastatic tumor in the atlantoaxial spine. Spine (Phila Pa 1976). 2002;27:1062–9.CrossRef
12.
George B, Archilli M, Cornelius JF. Bone tumors at the cranio-cervical junction. Surgical management and results from a series of 41 cases. Acta Neurochir (Wien). 2006;148:741–9. discussion 749.CrossRef
13.
Ibrahim A, Crockard A, Antonietti P, Boriani S, Bunger C, Gasbarrini A, et al. Does spinal surgery improve the quality of life for those with extradural (spinal) osseous metastases? An international multicenter prospective observational study of 223 patients. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2007. J Neurosurg Spine. 2008;8:271–8.CrossRefPubMed
14.
Fehlings MG, David KS, Vialle L, Vialle E, Setzer M, Vrionis FD. Decision making in the surgical treatment of cervical spine metastases. Spine (Phila Pa 1976). 2009;34:S108–17.CrossRef
15.
Perrin RG, Laxton AW. Metastatic spine disease: epidemiology, pathophysiology, and evaluation of patients. Neurosurg Clin N Am. 2004;15:365–73.CrossRefPubMed
16.
Mavrogenis AF, Guerra G, Romantini M, Romagnoli C, Casadei R, Ruggieri P. Tumours of the atlas and axis: a 37-year experience with diagnosis and management. Radiol Med. 2012;117:616–35.CrossRefPubMed
17.
Rao S, Badani K, Schildhauer T, Borges M. Metastatic malignancy of the cervical spine. A nonoperative history. Spine (Phila Pa 1976). 1992;17:S407–12.CrossRef
18.
Piper JG, Menezes AH. Management strategies for tumors of the axis vertebra. J Neurosurg. 1996;84:543–51.CrossRefPubMed
19.
Oda I, Abumi K, Ito M, Kotani Y, Oya T, Hasegawa K, et al. Palliative spinal reconstruction using cervical pedicle screws for metastatic lesions of the spine: a retrospective analysis of 32 cases. Spine (Phila Pa 1976). 2006;31:1439–44.CrossRef
20.
Patchell RA, Tibbs PA, Regine WF, Payne R, Saris S, Kryscio RJ, et al. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet. 2005;366:643–8.CrossRefPubMed
21.
Chuang HC, Wei ST, Lee HC, Chen CC, Lee WY, Cho DY. Preliminary experience of titanium mesh cages for pathological fracture of middle and lower cervical vertebrae. J Clin Neurosci. 2008;15:1210–5.CrossRefPubMed
22.
Heidecke V, Rainov NG, Burkert W. Results and outcome of neurosurgical treatment for extradural metastases in the cervical spine. Acta Neurochir (Wien). 2003;145:873–80. discussion 880–1.CrossRef
23.
Baker JF, Shafqat A, Devitt A, McCabe JP. Stabilization of metastatic lesions affecting the second cervical vertebra. J Craniovertebr Junction Spine. 2015;6:56–9.CrossRefPubMedPubMedCentral
24.
Yang X, Huang W, Xiao J, Wu Z, Feng D, Zheng W, et al. Combined pre- and retrovascular extraoral approach for tumors at lateral mass of the atlas. Spine (Phila Pa 1976). 2011;36:129–36.CrossRef
25.
McAfee PC, Bohlman HH, Riley Jr LH, Robinson RA, Southwick WO, Nachlas NE. The anterior retropharyngeal approach to the upper part of the cervical spine. J Bone Joint Surg Am. 1987;69:1371–83.CrossRefPubMed
26.
Hadley MN, Spetzler RF, Sonntag VK. The transoral approach to the superior cervical spine. A review of 53 cases of extradural cervicomedullary compression. J Neurosurg. 1989;71:16–23.CrossRefPubMed
27.
Menezes AH, VanGilder JC. Transoral-transpharyngeal approach to the anterior craniocervical junction. Ten-year experience with 72 patients. J Neurosurg. 1988;69:895–903.CrossRefPubMed
28.
Landeiro JA, Boechat S, Christoph Dde H, Goncalves MB, Castro I, Lapenta MA, et al. Transoral approach to the craniovertebral junction. Arq Neuropsiquiatr. 2007;65:1166–71.CrossRefPubMed
29.
Park SH, Sung JK, Lee SH, Park J, Hwang JH, Hwang SK. High anterior cervical approach to the upper cervical spine. Surg Neurol. 2007;68:519–24. discussion 524.CrossRefPubMed
30.
Jeszenszky D, Fekete TF, Melcher R, Harms J. C2 prosthesis: anterior upper cervical fixation device to reconstruct the second cervical vertebra. Eur Spine J. 2007;16:1695–700.CrossRefPubMedPubMedCentral
31.
Puttlitz CM, Harms J, Xu Z, Deviren V, Melcher RP. A biomechanical analysis of C2 corpectomy constructs. Spine J. 2007;7:210–5.CrossRefPubMed
32.
Tomita K, Kawahara N, Murakami H, Demura S. Total en bloc spondylectomy for spinal tumors: improvement of the technique and its associated basic background. J Orthop Sci. 2006;11:3–12.CrossRefPubMedPubMedCentral
33.
Rhines LD, Fourney DR, Siadati A, Suk I, Gokaslan ZL. En bloc resection of multilevel cervical chordoma with C-2 involvement. Case report and description of operative technique. J Neurosurg Spine. 2005;2:199–205.CrossRefPubMed
34.
Yang X, Wu Z, Xiao J, Teng H, Feng D, Huang W, et al. Sequentially staged resection and 2-column reconstruction for C2 tumors through a combined anterior retropharyngeal-posterior approach: surgical technique and results in 11 patients. Neurosurgery. 2011;69:ons184–93. discussion ons193-4.CrossRefPubMed
35.
Finkelstein JA, Zaveri G, Wai E, Vidmar M, Kreder H, Chow E. A population-based study of surgery for spinal metastases. Survival rates and complications. J Bone Joint Surg (Br). 2003;85:1045–50.CrossRef
36.
Arrigo RT, Kalanithi P, Cheng I, Alamin T, Carragee EJ, Mindea SA, et al. Predictors of survival after surgical treatment of spinal metastasis. Neurosurgery. 2011;68:674–81. discussion 681.CrossRefPubMed
Metadata
Title
Surgical treatment of upper cervical spine metastases: a retrospective study of 39 cases
Authors
Jian Yang
Qi Jia
Dongyu Peng
Wei Wan
Nanzhe Zhong
Yan Lou
Xiaopan Cai
Zhipeng Wu
Chenglong Zhao
Xinghai Yang
Jianru Xiao
Publication date
01-12-2017
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2017
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-016-1085-0

Other articles of this Issue 1/2017

World Journal of Surgical Oncology 1/2017 Go to the issue

Research

Combining serum miRNAs, CEA, and CYFRA21-1 with imaging and clinical features to distinguish benign and malignant pulmonary nodules: a pilot study

Research

Neoadjuvant treatment of pancreatic adenocarcinoma: a systematic review and meta-analysis of 5520 patients

Research

Effect of dendritic cell-cytokine-induced killer cells in patients with advanced colorectal cancer combined with first-line treatment

Technical innovations

An acetabular-preserving procedure for pelvic giant cell tumor involving partial acetabulum

Research

Statin consumption as a risk factor for developing colorectal cancer: a retrospective case study

Research

Restorative resection of radiation rectovaginal fistula can better relieve anorectal symptoms than colostomy only