Management of Cervical Spine Tumours

Abstract

Advancement in technology, radiotherapy, surgical approaches (anterior, posterior and combined) and technique improved the quality of cervical spine tumour management. Biopsy is necessary to establish the histological diagnosis. There are no precise guidelines concerning cervical spine tumour surgical management; therefore, this surgery needs to be tailored to the patient. In case of neurological deficits, surgery represents the best possibility to improve the probability of recovery. Chemotherapy, radiation therapy and hormone therapy could be administrable before or after surgery as adjuvant or neoadjuvant therapy. Cervical spinal tumour surgery may have two different aims: palliative or curative treatment. The former focuses on pain decrease, segmental stabilization and prevention of further injuries. It is usually chosen in case of osteoblastic metastases. Instead, surgery is mandatory for osteolytic lesions, and wide tumour excision, stabilization and bone reconstruction are required. In combined approaches, anterior plating and screws with plates or longitudinal bar and lateral mass screws posteriorly can be used.

Cervical spinal tumour surgery is burdened with a high rate of complications as vascular lesions, visceral structure injuries, neurological lesions, spinal cord canal lesions, bone graft and device complications, general complications and infections.