Paraplegia by Malignant Thoracic Vertebral Tumor: Neurological Outcome and Life Prognosis following Surgery
Tetsutaro Yahata, Katsuhiko Tachino, Fujiko Someya, Kenji Kagechika (Kanazawa University, Kanazawa, Japan)
Eighteen patients with paraplegia by malignant thoracic vertebral tumor (15 metastatic and 3 primary cancers) were assessed. Each patient showed paraplegia to some degree before surgery (Frankel A: 2, B: 4, C: 8 and D: 4 patients). Complete spinal decompression were performed to all patients by total spondylectomy, anterior decomplcssion, laminectomy or tumor resection. We reviewed the age, the injured level, the primary disease, the duration of paraplegia before surgery, the Frankel's grade just before surgery, and the recovery up to 1 year following surgery by Frankel's grade. As a result, there seems to be little benefit of surgery on recovery for motor complete paraplegia (Frankel A and B), but also 5 of them were dead within 1 year. On the contrary, the patients with motor incomplete paraplegia (Frankel C and D) showed good life prognosis up to 1 year following surgery, and also good neurological outcome, almost all of which were able to get community ambulation.
IMPAIRED HEMORHEOLOGY IN PATIENTS WITH POSTMASTECTOMY LYMPHEDEMA
Vcronika Fialka*, R. Koppenstcincr, I. Michl, M. Korpan*, A. Budinsky, E. Wiesinger
(Univ. Hospital, Vienna, Austria/Dept. of Phys. Med.& Rehab.*, Dept. of Int. Med.)
Purpose: Lymphedema (LE) of the arm is one of the most disabling and serious complications of breast cancer. Apart from tumor infiltration or fibrosis of lymphatic pathways, little is known about factors favouring the development of LE. In the present study, we evaluated the impact of rheologic parameters.
Method: red cell aggregation (EA), plasma viscosity (PV), capillary morphology and capillary flow were investigated in 36 patients with breast cancer 18 with and 18 without LE.
Result: There was no difference between the two groups regarding the type of surgery performed, the number of resected and of infiltrated lymph nodes, frequence of radio- and chemotherapy. Patients with LE showed significantly higher values of EA in stasis as well as in low shear as compared to patients without LE. There was no significant difference regarding plasma viscosity, capillary density and capillary flow.
Conclusion: Our data suggest further studies with drugs improving EA as pentoxiphylline, fibrates or coumarin in the prevention and follow up of patients with LE.