Metastases in the spine: symptoms and treatment

Metastases in the spine

Metastases in the spine- secondary malignant lesion of the spinal column that occurs when the tumor cells migrate from the focus located in another organ.

They are manifested by pain, sensitivity and movement disorders, paresis, paralysis, pelvic disorders, hypercalcemia and pathological fractures.

The diagnosis of "metastasis in the spine" is established taking into account anamnesis, general and neurological examination, roentgenography of the spine, CT of the spine and other diagnostic procedures.

Treatment - chemotherapy, radiotherapy, hormonal therapy, laminectomy, stabilizing surgery.

Compose 13% of the total number of cancer. There are more frequent primary neoplasias of the spinal column. In 80% of cases, metastases in the spine are diagnosed in lung cancer, breast and prostate cancer.

Often found in sarcomas and lymphomas. Any part of the spine can be affected. The thoracic and lumbar parts are more common, in the cervical spine metastases are relatively rare. The outlook is unfavorable.

Treatment is carried out by specialists in the field of oncology and vertebrology.

Classification of metastases in the spine

Taking into account the characteristic changes in bone substance, two types of metastases are identified in the spine:

• Osteolytic(osteoclastic) secondary foci - characterized by the predominant activation of osteoclasts that dissolve bone tissue. Accompanied by a visible decrease in the height of the vertebrae on radiographs.
• Osteoblastic(osteosclerotic) metastases in the spine - characterized by uncontrolled proliferation and increased density of bone tissue. On X-rays are manifested "spotting a change in shape and an increase in the volume of the affected bone. Along with the bodies, arches and processes of the vertebrae can be involved in the process.

Morphological structure of metastases in the spine is very variable and depends on the type of primary neoplasia.

In the process of histological examination, high- and low-grade and low-grade and anaplastic carcinomas, squamous cell carcinoma and other types of malignant tumors can be detected.

The first manifestation is usually pain syndrome. Pain more often blunt, aching, local, or spread beyond the level of damage.

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Intense pains with metastases in the spine may resemble a similar symptom in osteochondrosis, but differ from it by greater persistence and rapid progression.

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In the early stages of soreness with metastases in the spine may be minor, provoked by tapping on the vertebrae, turning the neck or lifting the straightened lower limb.

Later the pains become permanent, they remain at rest. A typical feature of metastases in the spine are nocturnal pains. Possible persistent local soreness, against which there is a feeling of "electric shock" during movements.

Places of "blows" coincide with the projection of the roots.

With metastases in the spine in the neck, the pain radiates to the upper limbs, with the lesion of the thoracic department girdles the trunk, with localization in the lumbar or sacral department given to the lower extremities.

When the process progresses, there are radicular disorders in the form of lumbosacral or cervico-brachial radiculitis.

In some patients, disorders of the pain sensitivity by the root type are determined.

For radicular pain with metastases in the spine, a certain cyclicity is characteristic: at the initial stage of the lesion of the next root the intensity of the pain syndrome increases, after its complete destruction disappears, then to reappear upon spreading to the next spine.

In patients with metastases in the spine polyneuropathies are detected in the form of paresthesias, a decrease in sensitivity by the type of stockings and gloves, hyperhidrosis and reddening of the distal parts of the extremities.

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Paresis and paralysis with metastases to the spine develop suddenly or gradually. There are violations of movement and sensitivity in combination with pelvic disorders.

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The features of the clinical picture are determined by the level of damage, the rate of progression compression, the location of metastasis in relation to the spinal cord and the peculiarities of the blood supply affected area.

Syndrome Brown-Sekar with metastases to the spine is rare.

With increased resorption of bone tissue, hypercalcemia may develop, manifested by drowsiness, inhibition, emotional lability, memory impairment, cognitive impairment, musculo-articular pain, impaired appetite, digestive disorders, arrhythmia, increased blood pressure, skin itching and other symptoms. Hypercalcemic disorders aggravate the patient's condition. In addition to the above manifestations caused by metastases in the spine, the patient can Symptoms caused by primary neoplasia and metastases located outside the vertebral column.

Diagnosis is made taking into account the medical history, clinical manifestations and additional examination.

At the same time, oncologists take into account that the symptoms of metastases in the spine can arise either simultaneously or almost simultaneously with the manifestations of primary neoplasia, and after a few months or even years after its radical treatment.

The absence of an oncological disease in an anamnesis is not an excuse for excluding metastases in the spine. Sometimes it is not possible to determine the localization of the primary process, despite the complex examination of the patient.

On the presence of cancer, a positive blood test for oncomarkers. At the initial stage of diagnosis, patients with suspected metastases in the spine are assigned a radiograph of the spine.

In the early stages of metastasis, radiologic signs of lesions of the vertebrae may be absent, so when a negative result of a study of patients with suspected metastases in the spine is directed to scintigraphy, CT and MRI the spine.

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To detect primary neoplasia and secondary foci, ultrasound of the abdominal cavity organs, chest radiography, mammography and other diagnostic procedures are performed.

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Differential diagnosis of metastases in the spine is performed with vascular lesions, consequences of inflammatory diseases, secondary demyelination and primary neoplasias vertebral column.

Treatment of metastases in the spine

The treatment plan is determined by the type and prevalence of the primary neoplasm, the general condition of the patient, the volume and manifestations of metastases in the spine.

The main goals of therapy are to reduce the pain syndrome, prevent or eliminate compression of the spinal cord, improve quality and increase the life expectancy of patients.

In the process of treatment of metastases in the spine, chemotherapy, diphosphonates, radiation therapy, hormonal therapy and surgical interventions are used.

To suppress bone resorption and eliminate hypercalcemia, diphosphonates are prescribed. Surgical procedures for metastases in the spine are usually palliative.

Indications for the operation are intense pain, progressive compression of the spinal cord, acute radicular syndrome with spinal instability and pathological fracture of the affected vertebra with compression of the dorsal the brain.

The amount of intervention depends on the condition of the patient with metastases in the spine, the prognosis of the disease, the type of neoplasia and the prevalence of lesions in the spinal column.

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All operations with metastases in the spine can be divided into two groups: decompressive and decompressive-stabilizing.

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Decompressive operations (laminectomy) are relatively simple and easier to tolerate by patients.

Their main disadvantage is the high probability of repeated deterioration of patients due to the progression of metastases and instability of the spinal column caused by laminectomy.

Decompression-stabilizing operations (using fixatives, implants, auto- and allografts) allow early to activate patients, provide a long-term effect and significantly improve the quality of life of patients with metastases in spine. The main disadvantages of such interventions are their high traumatism, the impossibility of carrying out in severe conditions and disseminated processes.

Prognosis for metastases in the spine

Metastases in the spine arise during the IV stage of the oncological process, which is considered to be prognostically unfavorable. At the same time, metastases in the bones proceed quite favorably in comparison with secondary lesions of the visceral organs.

The average life expectancy with metastases in the spine is from 1 to 2 years.

As unfavorable prognostic factors, rapid aggressive growth of primary neoplasia, multiple metastatic lesions of various organs, a short period of time between therapy of primary neoplasm and the occurrence of metastases in spine, large metastatic tumor size, absence of sclerosis signs on radiographs of the vertebrae before and after therapy, severe the patient's condition. Favorable prognostic factors are slow growth of the primary tumor, a single character of metastases in the spine, a small size of secondary neoplasia, the presence of signs of sclerosis on radiographs before and after therapy, a satisfactory condition patient.

A source: http://www.krasotaimedicina.ru/diseases/oncologic/spinal-metastasis

Metastases in the spine: symptoms and what to do with the disease, treatment and prognosis, possible complications

Oncological diseases in the modern world occupy one of the leading places in the structure of the causes of disability and mortality.

Malignant tumors are characterized by a long asymptomatic development, often diagnosed at a late stage of the process and not always amenable to radical cure.

Progression of many neoplasms leads to the formation of metastases in the spine. How to recognize these symptoms?

Definition of concept

The vertebral column is the main component of the entire bone system of the human body and carries the main support load.

Inside it is the vertebral canal, which contains the second most important control center for the nervous functions of the body - the spinal cord.

The main task of this body is to ensure the uninterrupted conduct of electrical signals from the brain to the rest of the anatomical formations.

Metastases in the spine are a secondary focus of malignant neoplasm, localized in bones, discs, spinal cord and its roots with the formation of appropriate neurological signs.

The formation of metastases in this zone, as a rule, indicates the fourth stage of the oncological process.

Metastasis in the spine is a sign of the late stage of the tumor process

Classification: metastases in the cervical, thoracic and other parts of the spine

Localization of metastases in the spine is divided:

• secondary tumor lesions in the cervical region that seizes the first seven segments of the spine;
• metastases in the thoracic region, located at the level of the following twelve segments of the spinal column;
• metastases in the lumbar region, characterized by the appearance of malignant foci in the following five segments of the spine;
• metastases in the lumbosacral spine afflicting the spine at the level of five lumbar and five sacral segments;
• secondary foci, which seize several segments of the spinal column.

Causes and factors of development

At the heart of any oncological process is the appearance in a particular organ of cells that do not correspond to its anatomical structure.The cause is, as a rule, genetic breakdown (mutation).

During a human life, similar emergency mutations occur many times in all types of tissues.

However, most such alien objects are recognized and destroyed by the body's immune system.

Metastasis is one of the main stages of the tumor process

Tumor cells are characterized by a rapid rate of reproduction, the germination of neighboring tissues and organs, the consumption of a large number of nutrients.

Such formations do not respond to any regulating signals from the body, tend to spread through the lymphatic system and form new points of tumor development - metastases.

The latter can be located both in the anatomical formations closest to the primary focus and away from the primary focus.

Clinical aspects of oncological diseases - video

Metastases in the spine may be a consequence of the progression of the tumor of any location, but there are a number of tumors in which this complication occurs more often. These include: prostate cancer, myeloma.

Spinal injury is extremely common for myeloma

The appearance of secondary tumor foci in the limited space of the spinal canal inevitably leads to compression of rootlets and spinal cord substance with the appearance of neurological symptoms corresponding to the level defeat.

Metastatic spinal injury leads to compression of the nerve roots and destruction of the spinal cord substance

Signs and symptoms of the disease: back pain, sensitivity disorders and other

The clinical picture of metastatic lesion of the anatomical spine formations consists of two main aspects: painful sensations of different localization and neurological disorders.

Pain syndrome is the main and the very first clinical sign of the development of a secondary tumor in the anatomical structures of the spinal column.These symptoms have some peculiarities.

Pain syndrome - the main sign of spinal injury by metastatic process

At the initial damage of the spine, acute painful sensations are observed in the neck, chest, back or perineum, depending on the localization of the metastatic focus. Later, when nerve fibers are destroyed at this level, the negative symptoms disappear for a short time, after which they resume under the influence of the involvement of adjacent structures in the oncological process.

Neurological symptoms affect the motor activity of the muscles and the sensitivity of the skin at various sites. The features of the clinical picture in this case are determined by the level of damage to the spinal cord.

Disturbance of sensitivity is a consequence of damage to the spinal cord substance by a metastatic process

Neurological disorders with different localization of the metastatic focus - table

Diagnostic methods, including radiography and MRI

Diagnostic measures for metastatic spinal injury are aimed at establishing the exact location of the secondary tumor and the degree of its growth.In parallel, the search for primary neoplasm is carried out. To perform these tasks, the doctor uses the following methods:

• examination of a neurologist with a thorough examination of all the details of the disease;
• the definition of reflexes, sensitivity, muscle strength and tone, the function of the pelvic organs to establish the level of damage to the spinal cord; review neurologist - the basis of diagnosis of metastases in the spine
• a general blood test to identify changes that are characteristic of the late stage of the oncological process: Reducing the level of red blood cells of erythrocytes and the main carrier of oxygen in the body - protein hemoglobin;
• analysis of blood for the presence of specific proteins - the satellite of a tumor of one or another localization (oncomarkers); Specific oncomarkers allow us to find the primary focus of the tumor
• Spinal puncture (spinal puncture) is used to obtain a cerebrospinal fluid, followed by its biochemical and microscopic analysis for detection of cells of the secondary tumor focus and determining its appearance; puncture puncture allows the identification of tumor cells contained in cerebrospinal fluid
• Radiography of the spine is used to establish the level of metastatic lesion and degree involvement in the process of various anatomical structures; Radiography is the first stage in the detection of metastases in the spine
• Chest X-ray of chest organs is the main method of searching for a primary tumor;
• ultrasound examination of the abdominal cavity and pelvic organs allows to detect the source of metastases in the spine;
• electroneuromyography is used to visualize the passage of a nerve electrical signal through the affected musculature and to determine the localization of the lesion;
• magnetic resonance imaging of the spinal column and spinal cord allows you to obtain an image of all segments of the spinal cord, identify the level and extent lesions of bones, discs and brain substance: agnitel-resonance tomography allows to precisely localize metastases and determine the degree of progression the process
• scintigraphy of the spine is based on the accumulation of a radioactive preparation by tumor cells and allows to diagnose metastases that are not visible during MRI.

Differential diagnosis is performed with the following diseases:

• Guillain-Barre syndrome;
• inflammation of the spinal cord (epiduritis);
• malignant neoplasm: primary lesion of the spinal cord; puhol spinal cord leads to the development of a clinical picture, identical to that of a metastatic lesion
• acute disturbance of the circulation of the spinal cord;
• a hernia of the intervertebral disc;
• inflammation of the spinal cord substance (myelitis);
• inflammation of spine cord root (sciatica).

Methods of treatment, including operational ones

The treatment is conducted under the guidance of an oncologist and related specialists: a neurosurgeon, a radiation therapist. To achieve the effect, a combination of several methods is used.

Medication

Anesthesia is an important method of therapy for metastases. For this purpose, various pharmacological preparations are used:

• non-narcotic drugs: Analgin, Ketorolac, Diclofenac, Dexalgin, Ketoprofen;
• drugs that have a narcotic effect: Morphine, Promedol, Omnopon, Tramal.

If the primary tumor site is sensitive to hormonal or chemotherapeutic treatment, then it is conducted by courses under the supervision of a specialist.

Anesthetics used to treat metastases in the spine - photo gallery

Analgin - the most common analgesic drug Diclofenac has analgesic and anti-inflammatory effectDecsalgin - modern anesthetic preparation Active substance Ketoprofen has a pronounced analgesic effect. Trimal is a prescription drug with a pronounced analgesic action Morphine is a potent prescription drug with a narcotic effect. Ketorolac has the most pronounced analgesic effect among non-narcotic substances

Radiation therapy

Treatment is carried out under the supervision of a radiologist. The possibility of using this method depends on the sensitivity of the primary tumor to X-ray irradiation.

The goal of this type of treatment is to stop malignant growth, to eliminate metastases. However, the healthy cells of neighboring tissues inevitably suffer.

It is necessary to carefully observe the dosage of X-ray irradiation and its targeted use.

Radiation therapy is a method of treating X-ray tumors

Surgery

The possibility of surgical treatment of metastases in the spine is determined by the doctor individually depending on the specific type of tumor, the degree of progression of the process and the patient's condition.

Unfortunately, surgical intervention does not lead to a radical cure for oncological pathology.The help of a surgeon is a way to improve a patient's quality of life, as far as possible in this situation.

Operative techniques are divided into two main types:

• Decompression, the purpose of which is the elimination of compression of the spinal cord and nerve roots. The main type of intervention is laminectomy - the removal of the arch of the vertebra. The main disadvantage of this method is the subsequent instability of the spinal column;
• decompression-stabilizing techniques are devoid of such a drawback. In addition to laminectomy, implantation of transplants from various materials strengthening the vertebral column (vertebroplasty) is used.

Modern equipment allows performing an operation without cuts through individual punctures using video control and laser technologies. The type of anesthesia is selected individually by the physician based on the type of intervention.

Vertebroplasty is an effective method of eliminating compression of the spinal cord structures and maintaining the stability of the spine

Complications and prognosis

When metastases of the primary tumor in the spine appear, survival, as a rule, does not exceed two years.

On the background of treatment, the following complications are possible:

• blood loss during surgery;
• suppuration of the wound;
• relapse of the tumor;
• immunosuppression against the background of the use of chemotherapeutic drugs and an increased risk of infectious complications;
• radiation sickness.

Prevention

The main method of prevention of advanced oncological processes is their timely diagnosis and treatment.

Metastases in the spine suggest the detection of an oncological process in later stages of development. All methods of treatment for this pathology are mainly aimed at improving the quality of life of the patient, and not provide a radical elimination of the tumor.

• Elena Timofeeva
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A source: http://lechenie-simptomy.ru/metastazyi-v-pozvonochnike-simptomyi

Metastases in the spine: symptoms. Metastases in the spine: manifestation

Cancer is a disease that can not be ignored. Moreover, it is important not only to react to the occurrence of a malignant tumor, but to do it as soon as possible.

It is also important to know that often the signs of some forms of cancer appear in the back, provoking noticeable symptoms.

Metastases in the spine, therefore, deserve special attention.

Relevance of the problem

The appearance of metastases in the back may be a consequence of the formation of a malignant tumor of the prostate and mammary gland, adrenal glands, kidneys and not only. In fact, in the area of ​​the spine can manifest any form of cancer.

Sometimes such reactions are possible even after several years from the end of treatment.

In some cases, such signs - metastases in the spine - can make themselves felt after a 20-year period of healthy life.

At such times, tumors should be treated with extreme seriousness, otherwise an extremely sad outcome is possible.

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As for the fact, in which part of the spinal column the secondary cancers appear, then it largely depends on the location of the primary tumor.

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For example, metastases in the cervical spine symptoms are manifested in phonemephosphoricomas or sarcomas of the nasopharynx. It is also worth noting that secondary signs can make themselves felt before the main focus.

Because of this, in some cases, the initial diagnosis is incorrect, although the fact that the patient is being diagnosed is already positive.

Why is this happening

In general, 13% of all diagnosed tumors are metastatic neoplasms located in the region of the vertebral canal.

In this case, the tumors themselves can be located both inside the spinal cord and outside it.

In the case of the last species, the location is possible under the dura mater and above it.

With such an issue as metastases in the spine, the symptoms allow to accurately diagnose the effect of the tumor in 90% of cases. The same cancer cells enter this area of ​​the body through the blood, and in some cases through the lymphatic ways and the lymph.

Main features

Regardless of the health problem, she always has symptoms. Metastases in the spine suggest that the body develops a cancerous tumor. There are a number of features that distinguish them from other diseases that form in the back area:

- the rapid development of complete or partial paralysis is possible;

- the pain manifests itself quickly, and similar sensations in the affected spine do not actually change even after using pain medications;

- with a change in the position of the body, the degree of pain increases significantly, which leads to a noticeable limitation of mobility;

- along with other signs of the disease, such neurological symptoms as loss of sensation, numbness and tingling are quickly manifested.

It should be understood that such a change in the patient's condition can also be accompanied by a significant deterioration in overall well-being. As a result, the patient has rapid weight loss, a violation of sleep and appetite. All this indicates a metastasis in the spine.

It is difficult to ignore such symptoms, but sometimes people even delay a visit to a doctor if they are in serious condition. Do not do this, because timely diagnosis and qualified treatment radically affect life expectancy in the case of cancer.

What forecasts can there be?

It is initially understood that the rapid development of symptoms is associated with the rapid progression of metastases. Primary tumor formations grow more slowly (a year and even longer), but with a secondary situation, the opposite is diametrically opposite.

It is for this reason, when such a diagnosis as a metastasis in the spine is fixed, the prognosis is often unfavorable.

However, it largely depends on the stage of the disease.

In this regard, it is worth repeating once again that the earlier a problem is identified, such as secondary cancers, the greater the chances of a positive outcome.

Also important role is played by the fact, which metastases are recorded in the spine. Symptoms and manifestations that indicate secondary formations of a previously removed tumor require special treatment.

Clinical picture

Depending on the size and number of formations, the symptoms may change.

Metastases in the spine are also able to differently affect the patient's condition, developing in certain parts of the spine.

This is not surprising, because every vertebra is in close proximity to the arteries and nerve roots, connected to various organs and parts of the body.

When there are metastases in the cervical spine, the symptoms are reduced to pain when trying to rotate the head or tilt it. Also, because of the compression of the vertebral artery, many patients begin to suffer from headaches and occasional dizziness.

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The metastases in the lumbar spine are different. Symptoms and changes in the condition require professional diagnosis, as they are very similar to the problems accompanying various kidney diseases.

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Sometimes, with such metastases, a strong static stress is possible, which can lead to a fracture of the compression-type vertebrae, which significantly distort the posture.

But this is not all, such fractures sometimes cause damage to the spinal cord, which results in partial or complete paralysis of the lower extremities.

When metastases are diagnosed in the thoracic spine, the symptoms are mostly unpleasant or pain in the area between the shoulder blades. It is worth knowing that this type of tumor manifestation becomes noticeable later than others, in view of its anatomical features.

Radicular disorders

In this case, the occurrence of so-called radicular pain is implied.

They can appear in the cervical region, and sometimes make themselves felt through the lumbosacral radiculitis.

It all depends on where the hearth is located. In some cases, the surrounding nature of pain is possible.

Also, there are positive symptoms of tension and soreness when feeling the spinous processes.

Other symptoms are also possible - metastases in the spine sometimes lead to inhibition of Achilles and knee reflexes.

Sometimes the pain is completely gone for a while, but in most cases it means not recovery, but complete destruction of the initially affected nerve root. Subsequently, when the tumor spreads to other nerve fibers, the pain resumes.

Myelitic syndrome

This condition is a consequence of the compression of the spinal cord tumor. Such cases often occur with prostate cancer, thyroid gland, with malignant lesions of the lung and breast.

The compression of this type can be fixed in any part of the spine, but most often the effect on the spinal cord occurs in the thoracic region. Often the degree of increase in pressure increases rapidly, but a slow change in the patient's condition is possible.

In this case, the pain syndrome manifests itself much earlier than other symptoms. Metastases in the spine can lead to the development of flaccid paralysis, which causes a complete loss of sensitivity of the conductor type. But this happens only with a sudden squeezing.

The pain itself is of a local nature and is felt in the area of ​​tumor lesion of the spine.

Polyneuropathic syndrome

Such a syndrome is characterized by the development of paresthesias, increased sweating of feet and brushes, as well as concomitant hyperemia with oppression of achilles, knee reflexes and eating disorders. In addition, there may be a reduced sensitivity by the type of stockings and gloves in the area of ​​the hands and feet.

In 4% of cases of tumor lesions of the spine, they are known to know intramedullary metastases in the spinal cord.

It is worth knowing about the fact that the diagnosis is most accurately posed in patients with radicular or localized pain, as well as with spinal cord expansion and progressive bilateral paresis.

Metastases in the spine: symptoms before death

In a neglected state, cancer leads to disruption of metabolic processes, and throughout the body. The local symptoms also increase markedly.

This means that the destruction of the spine at the sites of tumor exposure reaches a critical level. There is also severe vomiting and nausea, headaches, anemia.

To the dying symptoms is a change in the rhythm of breathing: it is fast, then practically stops.

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In severe patients, a decrease or increase in temperature is observed, which is well below the permissible norm.

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Symptomatic of this kind includes apathy, indifference and loss of interest in everything that is happening.

Also, a man whose death is near, almost does not eat and drinks very little. All this is accompanied by excessive weakness and drowsiness. Even hallucinations are possible.

The result

Cancer is a disease whose outcome largely depends on timely diagnosis.

Therefore, if any signs resembling metastases in the spine were seen, you should immediately go to the hospital.

If suspicions are confirmed, professional treatment can significantly extend the life of the patient.

A source: http://.ru/article/263148/metastazyi-v-pozvonochnike-simptomyi-metastazyi-v-pozvonochnike-proyavlenie

Metastases in the cervical, thoracic and lumbar spine: symptoms, treatment, prognosis, photo

Secondary tumor formations that spread the primary malignant tumor to other organs and tissues are called metastases.

On the share of all bone malignant neoplasms, about 90% have a metastatic character, i.e., are secondary.

The peculiarity of bone metastasis is its multiple nature.

Usually vertebral metastasis is observed in such types of cancer as:

Metastases are no less dangerous to the body than the primary tumor itself.

They are able to destroy bone tissue and cause osteoporosis, and with the growth of metastases along the nervous roots and spinal structures can occur compression, which manifests itself as a neurological symptomatology.

Usually vertebral metastasis in renal cancer spreads through the bloodstream. Usually, the defeat of the osseous system begins with the venous epidural plexus - it is in this zone that the atypical malignant cells enter the bone structures.

If the metastases in kidney cancer penetrated the vertebral tissues, then this indicates that the oncoprocess came to the III-IV stage.

The main sign of vertebrate metastasis in malignant damage to the kidneys is an intense pain syndrome, and from radicular soreness it is characterized by strength and stability.

about the surgical treatment of metastases of kidney cancer in the spine:

Classification

Bone metastases are divided into:

1. Osteoblastic- which is characterized by uncontrolled increase and proliferation of bone tissue. On X-ray images, these metastases look like a speckled spot, they increase the affected bone and change its shape.
2. Osteolytic- for them, typical dissolution of bone tissue, which is associated with abnormal activity of osteoclasts. On the X-ray, this metastasis is manifested by a decrease in the height of the vertebral parts.

There are many variants of vertebral metastasis in terms of morphological characteristics.

According to the histological data, they are subdivided into squamous cell carcinoma, anaplastic carcinomatous education, low medium- and highly differentiated cancers, as well as other types formations.

Symptoms of metastases in the spine

For any metastatic formation, the presence of tenderness is characteristic, which is predominantly local, aching and dull, rarely spreading beyond the boundaries of the affected department.

In contrast to osteochondrosis, the metastatic pain syndrome rapidly progresses and is more intense.

However, in the early stages of development, pain syndrome can occur only after certain actions, for example, after turning the neck or a wave of the hand, or after tapping on the vertebrae.

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With the development of the oncopathological process, the pain symptoms become permanent, it can persist even in a calm state. Particularly concerned about pain at night, and when driving they resemble an electric shock.

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A characteristic sign of metastasis in the vertebrae is paresthesia and hyperhidrosis, a decreased sensitivity of the feet and palms.

Often disturbed by motor disorders, coupled with disorders of the pelvic region.

In the cervical part

If metastasis is localized in the cervical vertebrae, the pain syndrome appears immediately, and the metastatic formation rapidly develops and grows.

The clinical picture as a whole boils down to the severe pain that occurs when trying to tilt or turn the head. In connection with the compression of the arteries of the spine, cancer patients begin to worry about frequent dizziness and headaches.

In the thoracic department

With such a localization of vertebral metastasis, cancer patients begin to be disturbed by discomfort-painful sensations in the interblade zone.

Such metastases usually manifest later lumbar and cervical, which is due to the peculiarities of the anatomy of the thoracic vertebral department.

Lumbar

The clinical picture of lumbar metastasis differs somewhat from the rest of the localizations of secondary cancers. It is characterized by signs of various kinds of kidney pathologies.

Such metastases can cause a strong static stress, which is fraught with compression vertebral fractures that distort the posture. Such injuries often lead to spinal injuries, causing paralysis of the legs of a full or partial nature.

Diagnostics

The primary task in detecting vertebral metastasis is to determine the primary cancerous focus. There are such procedures as magnetic resonance imaging or CT, X-ray examination of the affected area.

It also shows:

Photo MRI and PET diagnosis of metastases in the spine

The final stage of diagnosis is biopsy, but with vertebral localization of the tumor process or its location in the cerebrospinal fluid, biopsy is not always possible.

Treatment

As always, the approach to treatment is determined by the prevalence and type of the primary oncochamber, the extent of metastasis and the volume of the secondary tumor process.

The main goal is to get rid of the pain syndrome, prevent or eliminate spinal compression, increase life expectancy and improve the life of the oncogene.For this, the following methods are used:

Usually, surgical manipulations are resorted to in cases when the formed tumor poses a mortal danger for the oncological. But, for example, with metastasis in the cervical spine, this method is not suitable, because such a localization is very difficult.

Importance of pain relief:

• For anesthesia in the early stages of drugs used such as Ibuprofen and Ketoprofen, Nimesulid, etc .;
• Medium intensity pains already require the use of opioid analgesics like Promedol, Prosidol or Tramadol;
• In the 3-4 stages of the tumor process, pain relief is indicated with such drugs as Buprenorphine, Fentanyl, or a variety of morphine forms.

Surgical intervention is performed endoscopically, if the metastases are large, then removal through the opening of the tissues is indicated. In this case, the neurosurgeon removes all tissues that have been metastasized.

Sometimes there are situations when secondary tumors grow to too large a size, then any interference can threaten the life of the cancer patient, so such metastases do not touch. If oncomprocess has reached the terminal stage, then palliative therapy is applied, designed to eliminate intolerable soreness.

Chemotherapy treatment is used in the treatment of primary oncochamber with metastasis in other organs. Usually the chemotherapy complex includes about 7-12 sessions, conducted daily.

Most often, vertebral metastasis occurs already at the final stages of the primary oncological process, which in themselves are prognostically unfavorable.

On average, the life expectancy of such patients can reach 1-2 years.

If the primary tumor is characterized by aggressive growth, multiple metastasis in other organic structures, or the course of oncology is characterized by early metastasis after surgical removal of the primary focus, large size of the vertebral metastasis and severe condition of the patient, it is said about the presence of prognostically unfavorable factors.

With small tumors in the spine and slow development of the main oncochamber, survival forecasts are more favorable.

Unfortunately, on average, metastasis to the spine is characterized by low survival rates, in more than 90% of cases, patients do not survive for 2 years.

A source: http://gidmed.com/onkologiya/oslozhneniya/metastazy-v-pozvonochnike.html