| ABSTRACT: |
Primary osseous neoplasms of the thoracic and
lumbar spine are uncommon lesions. Between 1965 and 1982, of 1971 patients
with musculoskeletal neoplasms, only 29 (1.5%) had primary osseous tumors
in these locations. There were eight children and 21 adults. Back pain was
the most common complaint in 25 patients (86%), and neurologic symptoms
or deficits were present in 16 patients (55%). All lesions were visible
on routine spine roentgenograms, while computed tomography and myelography
demonstrated spinal canal encroachment and extradural spinal cord compression
in 19 patients (66%). The histologic diagnoses included 11 benign and 18
malignant lesions. Benign lesions occurred predominantly in children and
malignant tumors in adults. Treatment was individualized, based on the histologic
diagnoses. Twenty-two patients had surgical resection of their lesions.
Laminectomy without stabilization and arthrodesis resulted in late instability
and neurologic deterioration in three of seven patients (43%) with malignant
lesions. Resection and decompression combined with arthrodesis did not predispose
to late instability. Twenty-one patients were followed for a mean of 4.1
years (range, two to 14 years). Eight patients died from malignant disease
between one month and seven years after diagnosis. |