Cancer metastases in the spine
Tumor metastases in the bone are quite common in oncology. This manifestation of the tumor process is one of the frequently observed factors. Primary malignant tumors of the spine are rare. Most often, the spine is affected by metastases. They are multiple and single. The cause of metastases in the vertebrae is most likely a primary cancerous tumor, less often they come from a sarcoma.
The spinal cord transmits nerve impulses from the brain to organs, muscles and to all parts of the body and, conversely, from the body to the brain. Accordingly, when the spinal cord malfunctions due to metastases, various changes in the patient's condition occur. In women, metastases in the spine grow in cancer of the breast, genitourinary organs, thyroid gland, in men, their spread occurs in cancer of the prostate, kidney, lungs. Usually, primary malignant tumors and their metastases do not appear for a long time, but are detected during radiation examination.
The favorite sites for metastases are the lower thoracic and upper lumbar vertebrae. In most cases, they are multiple in the spine. The pathological process of metastatic lesions of the spine is the destruction of the bone substance of the vertebral bodies, the ability to fracture is noted, and a focus of osteoporosis is formed. Metastases cause dull local pain in the affected vertebra, which is often confused with osteochondrosis.
The pain often occurs at night, and its increase is noted. Spinal pain is an alarming symptom, the strength of painful prolapse indicates the degree of destruction of the vertebra. The radicular symptoms of metastases in the spine are expressed by irritation of the nerve endings as a result of the destruction of the vertebral bodies. Compression of the spinal cord ends with paresis and paralysis, impaired digestion and the work of the urinary system.
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Methods for diagnosing spinal metastases include:
- angiography with contrast (X-ray), it is prescribed to obtain the state of the vessels that feed the metastases of the spine. With the help of angiography, the nature of the metastases in the spine is determined and it is checked for new tumor nodes and lesions.
- the radionuclide method also accurately determines the metastases in the spine and the extent of their spread.
- aspiration biopsy - allows you to obtain data on the structure of metastases in the spine. A biopsy is the definitive diagnosis that detects the presence of metastases in the spine using the histology of a tissue sample.
- magnetic resonance imaging is a method that most reliably determines the presence of metastases in the spine, the condition of the bone under the periosteum, with its help it is seen how the tumor grows beyond the periosteum.
Treatment of metastases in the spine is carried out using radiotherapy, chemotherapy, hormone therapy, if this is associated with developing cancer of the breast, ovaries, etc., with persistent pain syndrome, surgery is.
Good results are obtained by the method of decompression laminectomy or decompression-stabilizing laminectomy with the formation of an anterior or posterior support complex. Posterior decompression during laminectomy allows extensive resection, since the traditional posterior approach is difficult, since epidural metastases grow from the vertebrae and are located in front of the spinal cord, another method cannot be used.
After this operation, the patient is prescribed local radiation therapy in order to exclude further development of metastases. Anterior decompression is performed through the anterior approach, which has an amazing effect and the ability to get rid of the tumor. According to experimental and clinical data, treatment with corticosteroids reduces local edema and has an antitumor effect. Foci of metastases in the spine capture the body, arches, processes of the vertebrae and intervertebral discs.
In the advanced stage, there is a curvature of the spine - kyphoscoliosis of the thoracic region. The vertebrae located above each other are weakened by metastases, as a result, they are flattened and displaced. In such a period, the most important thing is the complication of metastases, i.e. compression of the spinal cord, which can lead to disability (paralysis). Symptoms of this process in the spinal cord can be pain in the lumbar spine, legs, weakness, frequent urge to urinate and defecate. Any unpleasant sensations and discomfort that arise should be reported to the doctor in order to diagnose and begin treatment on time.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
