Summary
In a retrospective study of 172 patients with disseminated carcinoma in the skeleton, 54% were shown by radiography and scintigraphy to have vertebral metastases. Breast carcinoma was the most common primary tumour, occurring in 30% of the patients, followed by lung (17%), prostate (10%) and kidney (9%). The lumbar spine was most often involved and some primary carcinomas showed a predilection for particular spinal segments. Cord compression occurred in 30% of the patients with vertebral spread and was a poor prognostic sign for long-term survival. Hypernephroma was the most common tumour to cause spinal cord involvement. The thoracic segment was the most frequent site of cord compression (43%), and pathological fracture-dislocation was the most common cause (50%).
Résumé
Une étude rétrospective portant sur 172 patients atteints de métastases osseuses carcinomateuses montre que 54% d'entre eux ont des métastases vertèbrales décelées à la radiographie et à la scintigraphie. Parmi celles-ci, le carcinome mammaire est la tumeur primitive la plus fréquente (30%), suivi par le cancer du poumon (17%), de la prostate (10%) et du rein (9%). La distribution segmentaire des métastases vertèbrales montre que la colonne lombaire est la plus fréquemment atteinte, et qu'il existe une affinité métastatique sélective de certains carcinomes pour des segments vertèbraux particuliers. L'apparition d'un syndrôme de compression médullaire, qui survient dans 30% des cas de dissémination vertèbrale, assombrit significativement le pronostic des ces malades. L'hypernéphrome a une propension marquée à entraîner une compression neurologique (4/8). C'est le segment dorsal qui est le plus exposé à la compression médullaire, secondaire dans 50% des cas à une fracture-luxation du corps vertèbral.
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Nottebaert, M., von Hochstetter, A.R., Exner, G.U. et al. Metastatic carcinoma of the spine. International Orthopaedics 11, 345–348 (1987). https://doi.org/10.1007/BF00271312
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DOI: https://doi.org/10.1007/BF00271312