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Metastatic epidural spinal cord compression. Results of treatment and survival.

https://arctichealth.org/en/permalink/ahliterature25228
Source
Cancer. 1990 Apr 1;65(7):1502-8
Publication Type
Article
Date
Apr-1-1990
Author
S. Sørensen
S E Børgesen
K. Rohde
B. Rasmusson
F. Bach
T. Bøge-Rasmussen
P. Stjernholm
B H Larsen
N. Agerlin
F. Gjerris
Author Affiliation
University Department of Neurology, Rigshospitalet, Copenhagen, Denmark.
Source
Cancer. 1990 Apr 1;65(7):1502-8
Date
Apr-1-1990
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Cauda Equina
Child
Combined Modality Therapy
Epidural Neoplasms - complications - secondary - therapy
Female
Gait - physiology
Humans
Laminectomy
Male
Middle Aged
Myelography
Nerve Compression Syndromes - etiology - physiopathology - therapy
Retrospective Studies
Spinal Cord Compression - etiology - physiopathology - therapy
Survival Rate
Tomography, X-Ray Computed
Abstract
All medical records of patients treated for metastatic compression of the spinal cord or cauda equina in the eastern part of Denmark from 1979 through 1985 were reviewed. With regard to treatment response and survival, 345 patients could be evaluated. Carcinoma of the lung (19%), prostate (18%), breast (13%), and kidney (10%) were the most frequent primary malignancies causing spinal compression. The outcome of treatment depended primarily on the patients' condition at the time of diagnosis: 79% of the patients who were able to walk before the treatment remained ambulatory, whereas only 21% of the nonambulatory paraplegic patients and 6% of the paralytic patients regained walking ability. Patients treated with laminectomy followed by radiotherapy seemed to respond better than patients treated with radiotherapy or laminectomy alone, but when the patients' pretreatment motor function was taken into account no significant difference was found between the three forms of treatment. In the subgroup of nonambulatory patients, however, a significantly better restoration of gait was observed in patients treated with the combination of laminectomy and radiotherapy than in patients treated with radiotherapy alone. A longer survival in the group treated with the combination of laminectomy and radiotherapy may reflect that these patients were in a lower stage of disease and thus had a better potential of regaining motor function. The results call for prospective randomized studies.
PubMed ID
2311062 View in PubMed
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[Metastatic spinal compression syndrome. Symptoms, diagnosis, treatment and prognosis]

https://arctichealth.org/en/permalink/ahliterature25052
Source
Ugeskr Laeger. 1990 Dec 3;152(49):3691-5
Publication Type
Article
Date
Dec-3-1990
Author
B H Larsen
K. Rohde
S E Børgesen
P S Sørensen
N. Agerlin
F. Bach
T. Bøge-Rasmussen
F. Gjerris
B U Rasmusson
P M Stjernholm
Author Affiliation
Rigshospitalet, København, neuromedicinsk, neurokirurgisk og onkologisk, afdeling.
Source
Ugeskr Laeger. 1990 Dec 3;152(49):3691-5
Date
Dec-3-1990
Language
Danish
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Cauda Equina - pathology
English Abstract
Female
Humans
Male
Middle Aged
Nerve Compression Syndromes - diagnosis - etiology - therapy
Prognosis
Retrospective Studies
Spinal Cord Compression - diagnosis - etiology - therapy
Spinal Cord Neoplasms - diagnosis - secondary - therapy
Abstract
A retrospective study of 398 patients suffering from metastatic compression of the spinal cord or cauda equina is presented. The study comprised almost all relevant medical records of patients admitted to hospital in the eastern part of Denmark in the period 1979 through 1985. Carcinoma of the lung, prostate, breast and kidney were the most frequent primary malignancies causing spinal compression. Most patients were treated with laminectomy, or radiotherapy or with laminectomy and radiotherapy combined. The effect of the treatment was estimated by evaluation of motor function and sphincter control. Treatment with laminectomy followed by radiotherapy was significantly superior to treatment with laminectomy or radiotherapy alone. But if the patients' motor function and primary tumour were taken into account, no significant difference between the treatments was observed. The efficacy of treatment depended upon the symptoms when the diagnosis was established, and accordingly early diagnosis is of the utmost importance. The incidence of metastatic compression increased during the period covered by the study, and since this condition must not go untreated, awareness of the symptoms, primarily pain, is essential.
PubMed ID
2264169 View in PubMed
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Metastatic spinal cord compression. Occurrence, symptoms, clinical presentations and prognosis in 398 patients with spinal cord compression.

https://arctichealth.org/en/permalink/ahliterature25382
Source
Acta Neurochir (Wien). 1990;107(1-2):37-43
Publication Type
Article
Date
1990
Author
F. Bach
B H Larsen
K. Rohde
S E Børgesen
F. Gjerris
T. Bøge-Rasmussen
N. Agerlin
B. Rasmusson
P. Stjernholm
P S Sørensen
Author Affiliation
Department of Oncology, University Hospital Herlev, Denmark.
Source
Acta Neurochir (Wien). 1990;107(1-2):37-43
Date
1990
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Humans
Middle Aged
Sex Factors
Spinal Cord Compression - etiology - physiopathology - therapy
Spinal Cord Neoplasms - complications - physiopathology - secondary - therapy
Survival Analysis
Abstract
We reviewed all medical records concerning patients suffering from spinal cord or cauda equina compression (SCC) secondary to cancer, in the eastern part of Denmark, from 1979 through 1985. During the period the incidence of SCC in cancer patients went up from 4.4% to 6%. However, this increase was not significant. The series comprised 398 cases, with carcinoma of the prostate (19%), lung (18%), breast (14%) and kidney (10%) accounting for 61%. The symptoms were evaluated in accordance with the patients rating of pain, motor deficits, sphincter control and paraesthesia, whereas the clinical manifestations were classified on the basis of motor deficit and bladder dysfunction. During the period preceding the diagnosis of SCC, 83% of the patients suffered from back pain, 67% from deteriorating gait and 48% had retention of the urine. In 35% of the patients there was no sphincter disturbance and 10% had normal sensory function. The outcome of treatment was estimated by changes in motor deficits and sphincter function, and depended primarily on the patients condition at the time of the diagnosis. Of the patients who were able to walk before treatment, 79% remained ambulatory, whereas only 18% of the non-ambulatory patients regained walking ability. Patients treated by decompressive laminectomy followed by radiotherapy apparently had a better response than patients treated with surgery or irradiation alone, but when the patients pre-treatment motor function was taken into account, no significant difference was observed. The study may call for a properly randomized trial with careful stratification of tumour biology, performance status and neurological deficits.
PubMed ID
2096606 View in PubMed
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Thoracic intervertebral disc herniation.

https://arctichealth.org/en/permalink/ahliterature251758
Source
Acta Neurol Scand. 1975 Nov;52(5):395-400
Publication Type
Article
Date
Nov-1975
Author
F. Gjerris
B V Jepsen
Author Affiliation
The University Clinic of Neurosurgery, Rigshospitalet, Copenhagen, Denmark.
Source
Acta Neurol Scand. 1975 Nov;52(5):395-400
Date
Nov-1975
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Denmark
Diskectomy
Female
Follow-Up Studies
Humans
Intervertebral Disc Displacement - diagnosis - surgery
Laminectomy
Male
Middle Aged
Neurologic Examination
Paraparesis - diagnosis
Postoperative Complications - diagnosis
Spinal Cord Compression - diagnosis - surgery
Thoracic Vertebrae - surgery
Young Adult
Abstract
Twelve men and 8 women, aged 15-73 years, were operated upon for herniated thoracic intervertebral disc during the years 1946 to 1972. The average duration of the symptoms was 14-15 months (range 4 days to 5 years). The most common symptom was back pain, with disturbances of sensibility or loss of power in one or both legs. On admission 13 patients had paraparesis. Laminectomy was carried out in all cases, and in two patients costotransversectomy was also performed. In six cases there was a transient exacerbation of the paraparesis after operation. 17 patients were followed up 2-25 years after operation. 13 had no neurological symptoms or signs, and two had slight loss of power in the legs. Of two patients who had paraparalysis before operation, one still suffered from paraparalysis, while the other had a moderately severe paraparesis.
PubMed ID
19899271 View in PubMed
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