The surgical treatment of cervical metastases.

The basic problem in dealing with metastatic deposits in the cervical spine is to treat the lesion in time, that is, prior to the onset of radicular or medullary involvement. This is always progressive and seriously affects the quality of remaining life in these patients. Early surgical intervention, in fact, makes it possible to free these patients from the prolonged use of orthoses which are often badly tolerated, facilitates easy nursing and often avoids or significantly reduces the pain due to these secondary lesions, so restoring a quality of residual life which is acceptable even in the context of neoplastic disease. After reviewing the world literature and the proposals of various authors, we present our own experience in 28 surgically treated cases. The advantages and disadvantages of the various techniques are discussed. Finally, a flexible metallic cervical prosthesis designed by the authors is presented. This is a shock-absorbent device which is fixed without cement.