1989 Fiscal Year Final Research Report Summary
STUDY OF EARLY DETECTION, ASSESSMENT OF DISEASE PROGRESS AND SURGICAL MANAGEMENT IN METASTATIC CANCER OF THE SPINE
| Project/Area Number |
63480341
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Orthopaedic surgery
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| Research Institution | OSAKA UNIVERSITY |
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Principal Investigator |
ONO Keiro OSAKA UNIVERSITY MEDICAL SCHOOL PROFESSOR AND CHAIRMAN, 医学部, 教授 (70028330)
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| Co-Investigator(Kenkyū-buntansha) |
YOSHIKAWA Hideki OSAKA UNIVERSITY MEDICAL SCHOOL ASSISTANT PROFESSOR, 医学部, 助手 (60191558)
FUJIWARA Keiju OSAKA UNIVERSITY MEDICAL SCHOOL ASSISTANT PROFESSOR, 医学部, 助手 (10199383)
EBARA Sohei OSAKA UNIVERSITY MEDICAL SCHOOL ASSISTANT PROFESSOR, 医学部, 助手 (40176780)
UCHIDA Atsumasa OSAKA UNIVERSITY MEDICAL SCHOOL LECTURER, 医学部, 講師 (40176681)
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| Project Period (FY) |
1988 – 1989
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| Keywords | MALIGNANT TUMOR / SPINAL METASTASIS / BONE SCINTIGRAPHY / STAGING SYSTEM / PROSTHESIS / SPINAL STABILITY / SPINAL CORD DECOMPRESSION / ANTERIOR APPROACH TO THE SPINE |
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| Research Abstract |
1)Diagnostic imaging modalities Bone scintigraphy with ^<99m>Tc phosphate proved to Provide the most sensitive image for early detection of spine metastases as compared to roentgen examination or ^<67>Ga citrate scintigraphy.
2)To establish a staging system in metastatic bone disease and to identify the risk factors promoting bone metastasis. Disease progress could be assessed with advancement in the stage: stage 1 bone metastasis in the central skeletal system (Th.L.and Ribs). stage 2 bone metastasis in the central and intermediate skeletal system(Central + Pelvis,Skull). stage 3 bone metastasis in the central, intermediate and peripheral skeletal system. Osteolytic nature of metastatic lesion and enhanced tumor marker activity often proved to be the risk factor.
3)Proposal of surgical management to cancer metastasis of the spine. Ceramic prosthesis was devised to replace the affected vertebra. Procedures to introduce the prosthesis and to anchor it into the spine were developed.
4)To test mechanical property of the prosthesis and mechanical strength of the vertebra-prosthesis-vertebra complex. The prosthesis anchored screws and bone cement provided a sufficient strength to bear body weight.
5)Indication, contraindication of the surgery, postoperaive managements and supportive cares for patients were established.
6)Postoperative radiotherapy onto the affected level of the spine proved to be the most effective measure for preventing local recurrence and sustaining surgical improvement.
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