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Medicine - Oncology & Hematology | Vertebral metastases

Vertebral metastases

Pointillart, Vincent, Ravaud, Alain, Palussiere, Jean

2002, 320 p.

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Tumors cells no longer confined to an affected organ can be released through lymph and the blood stream, disseminate and form metastases. Metastases to the spine are frequent, may be painful and may occur in an isolated or multiple level manner, they may lead to structural failure of the spinal column and cause com­ pression of nerve structures resulting in progressive paralysis or in painful radi­ culopathies. The dinical evaluation as weIl as to tumor pathophysiology are weIl explai­ ned in two general chapters and then each specific primary tumor is analyzed in a specific chapter. The choice was made to offer a multidisciplinary approach. One may thus find similar aspects repeated in different chapters, yet this is ne ces­ sary since each part of this textbook can be used as a specific reference. I was impressed by the carefully detailed humane approach to the patient information with care for the patient's dignity. Truthful information is explained dearly enough to give all the elements the patient needs to understand and accept neces­ sary treatments with a responsible attitude. Previously, when confronted with a patient suffering from a debilitating spine metastasis of a malignant tumor it has been almost always too late to offer anything more than compassionate ineffica­ cy. Surgical treatment was balanced with life expectancy and then only rarely indicated in certain specific cases.

Content Level » Research

Keywords » Rehabilitation - Tumor - chirurgy - diagnosis - diagnostic - diagnostics - physiology - radiotherapy - surgery - therapy - vertebrales metastasis - vertebroplasty

Related subjects » Medicine - Oncology & Hematology - Orthopedics - Radiology - Surgery

Table of contents 

Comprehensive patient care and information presented to patients.- Metastasis of cancerous cells: Characteristics of osseous invasion.- Pathophysiology of vertebral metastases.- Symptoms of vertebral metastases.- Diagnosis.- Imaging of vertebral metastases.- Bone scintigraphy of vertebral metastases.- Percutaneous vertebral biopsy under radiological guidance.- Pathology.- Particular Aspects and Specific Treatment Depending on the Primary Cancer.- Vertebral metastases of breast cancers.- Vertebral metastases of renal cancers.- Vertebral metastases of thyroid cancer.- Vertebral metastases of prostate cancer.- Vertebral metastases of lung cancer.- Vertebral metastases of hematologic malignancies.- Osseous metastases of digestive cancers.- Osseous metastases of rare tumors.- Vertebral metastases of cancers of unknown primary origin.- Surgical treatment.- Indications of surgery in the treatment of vertebral metastases.- Surgery of cervical vertebral metastases.- Anterior approaches to the thoracic and thorocolumbar spine.- Treatment of thoracic vertebral metastases by thoracoscopy: Technique and results.- Posterior thoracic and lumbar approach.- Vertebrectomy in the treatment of vertebral metastases.- Recurrences, new metastases and complications.- Perioperative nursing care and psychological management.- Perioperative anesthetic management: Assessment of risk, intraoperative period, postoperative period and systemic complications.- Functional rehabilitation management of patients operated for vertebral metastases.- Interventional radiology.- Vertebroplasty.- Preoperative embolization of hypervascularized vertebral tumors.- Medical treatment.- Bisphosphonates and osseous metastases.- Symptomatic treatments of the pain of vertebral metastases.- Radiotherapy.- Strategic and decision-making tress.- Analysis of result.- Analysis of the literature and annotated critical bibliography.

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