Neurol. pro Praxi, 2003; 5: 236-241

Metastatické postižení páteřního sloupce, míchy a míšních obalů

MUDr. David Doležil Ph.D
Neurologická klinika FNsP Ostrava-Poruba

Keywords: metastázy páteře, metastázy míšní, leptomeningeální metastázy, diferenciální diagnóza, terapie.

Published: December 31, 2003  Show citation

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Doležil D. Metastatické postižení páteřního sloupce, míchy a míšních obalů. Neurol. praxi. 2003;4(5):236-241.

Metastatické postižení v oblasti páteře je častou manifestací maligních nádorů a jeho incidence se zvyšuje v souvislosti s délkou přežívání pacientů s nádorovým onemocněním, které je dáno novými léčebnými postupy. Metastázy mohou postihnout obratle, míchu i míšní pleny. Solidní metastázy mohou být uloženy extradurálně, intradurálně extramedulárně nebo mohou zasahovat intramedulárně. Diferenciálně diagnosticky je nutno zejména odlišit tyto procesy od specifického i nespecifického zánětlivého postižení a primárních nádorů. Péče o pacienty s metastatickým postižením páteře musí být multidisciplinární, kdy kromě přesné diagnózy etiologické a topické neurologem a radiologem je potřeba zvážit terapii chirurgickou, chemoterapii a radioterapii, resp. kombinaci těchto léčebných přístupů. S určitými diagnostickými obtížemi může být spojeno metastatické postižení epidurálního prostoru a leptomeningeální metastatický proces, které mohou mít víceložiskovou symptomatiku. Oba tyto metastatické procesy jsou navíc i špatně terapeuticky ovlivnitelné. Přinášíme souhrnnou informaci o příznacích, diagnostice, specifické a adjuvantní terapii metastáz v oblasti páteře.

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    References

    1. Connolly ES Jr, Winfree CJ, McCormick PC, et al. Intramedullary spinal cord metastasis: report of three cases and review of the literature. Surg Neurol 1996; 46: 329-338. Go to original source... Go to PubMed...
    2. Cooper PR, Errico TJ, Martin R, et al. A systematic approach to spinal reconstruction after anterior decompression for neoplastic disease of the thoracic and lumbar spine. Neurosurgery 1993; 32: 1-8. Go to original source... Go to PubMed...
    3. Ghogawala Z, Mansfield FL, Borges LF. Spinal radiation before surgical decompression adversely affects outcomes of surgery for symptomatic metastatic spinal cord compression. Spine 2001; 26: 818-824. Go to original source... Go to PubMed...
    4. Helweg-Larsen S. Clinical outcomes in metastatic spinal cord compression. A prospective study of 153 patients. Acta Neurol Scand 1996; 94: 269-275. Go to original source... Go to PubMed...
    5. Chamberlain MC. New approaches to and current treatment of leptomeningeal metastases. Curr Opin Neurol 1994; 7: 492-500. Go to original source... Go to PubMed...
    6. Katagiri H, Takahashi M, Inagaki J, et al. Clinical results of nonsurgical treatment for spinal metastases. Int J Radiat Oncol Biol Phys 1998; 42: 1127-1132. Go to original source... Go to PubMed...
    7. Kim HJ, Ryu KN, Choi WS, et al. Spinal involvement of hematopoietic malignancies and metastasis: differentiation using MR imaging. Clin Imaging 1999; 23: 125-133. Go to original source... Go to PubMed...
    8. Kokkoris ChP. Leptomeningeal carcinomatosis. Cancer 1983; 51: 154-160. Go to original source...
    9. Perrin RG, Livingston KE. Neurosurgical treatment of pathological fracture-dislocation of the spine. J Neurosurg 1980; 52: 330-334. Go to original source... Go to PubMed...
    10. Perrin RG, McBroom RJ. Anterior versus posterior decompression for symptomatic spinal metastasis. Can J Neurol Sci 1987; 14: 75-80. Go to original source... Go to PubMed...
    11. Schick U, Marquardt G, Lorenz R. Intradural and extradural metastases. Neurosurg Rev 2001; 24: 1-7. Go to original source... Go to PubMed...
    12. Schiff D, O'Neill BP. Intramedullary spinal cord metastases: clinical features and treatment outcome. Neurology 1996; 47: 906-912. Go to original source... Go to PubMed...
    13. Siegal T, Lossos A, Pfeffer MR. Leptomeningeal metastases: Analysis of 31 patiens with sustained off-therapy response following combined-modality therapy. Neurology 1994; 44: 51-63. Go to original source... Go to PubMed...
    14. Solberg A, Bremnes RM. Metastatic spinal cord compression: diagnostic delay, treatment, and outcome. Anticancer Res 1999; 19: 677-684. Go to PubMed...
    15. Sundaresan N, Digiancinto GV, Hughes JE, et al. Treatment of neoplastic spinal cord compression: results of a prospective study. Neurosurgery 1991; 29: 645-650. Go to original source... Go to PubMed...
    16. Ushio Y, Posner R, Kim JH, et al. Treatment of experimental spinal cord compression caused by epidural neoplasms. J Neurosurg 1977; 47: 380-390. Go to original source... Go to PubMed...
    17. Vecht CJ, Haaxma-Reiche H, van Putten WL, et al. Initial bolus of conventional versus high-dose dexamethasone in metastatic spinal cord compression. Neurology 1989; 39: 1255-1257. Go to original source... Go to PubMed...
    18. Weigel B, Maghsudi M, Neumann C, et al. Surgical management of symptomatic spinal metastases. Postoperative outcome and quality of life. Spine 1999; 24: 2240-2246. Go to original source... Go to PubMed...
    19. Zadat OO, Ruff RL. Treatment of spinal epidural metastasis improves patient survival and functional state. Neurology 2002; 58: 1360-1366. Go to original source... Go to PubMed...
    20. Zapletalová O, Höfer R, Hradílek P, Häringová M, Doležil D. Radiation-induced myelopathy. Euro J Neurol 2003; 10 (Suppl 1): 186.

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