Instability and impending instability in patients with vertebral metastatic disease
| Autor: | Nicolò Rumi, Alessandro Cianfoni, Cesare Colosimo, Maria Cristina Cortese, Viola Zecchi, Antonio Maria Leone |
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| Rok vydání: | 2018 |
| Předmět: |
030203 arthritis & rheumatology
Joint Instability medicine.medical_specialty Spinal Neoplasms business.industry medicine.medical_treatment Disease medicine.disease Radiosurgery 030218 nuclear medicine & medical imaging Vertebra Radiation therapy 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Spinal cord compression Orthopedic surgery medicine Humans Spinal Fractures Radiology Nuclear Medicine and imaging External beam radiotherapy Radiology business Pathological |
| Zdroj: | Skeletal radiology. 48(2) |
| ISSN: | 1432-2161 |
| Popis: | Metastatic disease commonly involves the spine with an increasing incidence due to a worldwide rise of cancer incidence and a longer survival of patients with osseous metastases. Metastases compromise the mechanical integrity of the vertebra and make it susceptible to fracture. Patients with pathological vertebral fracture often become symptomatic, with mechanical pain generally due to intervertebral instability, and may develop spinal cord compression and neurological deficits. Advances in imaging, radiotherapy, as well as in spinal surgery techniques, have allowed the evolution from conventional palliative external beam radiotherapy to modern stereotactic radiosurgery and from traditional open surgery to less-invasive, and sometimes prophylactic stabilization surgical treatments. It is therefore clear that fracture risk prediction, and maintenance or restoration of intervertebral stability, are important objectives in the management of these patients. Correlation between imaging findings and clinical manifestations is crucial, and a common knowledge base for treatment team members rather than a compartmentalized view is very important. This article reviews the literature on the imaging and clinical diagnosis of intervertebral instability and impending instability in the setting of spine metastatic disease, including the spinal instability neoplastic score, which is a reliable tool for diagnosing unstable or potentially unstable metastatic spinal lesions, and on the different elements considered for treatment. |
| Databáze: | OpenAIRE |
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