Maruo S, Mori Y, Uematsu K
Nihon Seikeigeka Gakkai Zasshi. 1981 Feb;55(2):199-208.
The radiological and histological studies were performed on the three spinal column obtained at autopsy from cases with metastatic tumors to the spine with complete paralysis treated surgically. These three cases consisted of a maxillary carcinoma with metastasis to the cervical spine, a seminoma with metastasis to the thoracic spine and a metastasized renal cell carcinoma to the thoracic spine. All patients died without recovery from the paralysis, in spite of the immediate tumor resection and spinal fusion were done immediately after the appearance of complete paralysis. The histological examination of cross section of these spinal column showed that tumor cells infiltrated in the vertebral body and spinal canal, and spinal cord was remarkably compressed by the tumor. Therefore, various degrees of degeneration were seen in the spinal cord. In addition, many tumor-cell emboli were seen in veins of vertebral body and spinal canal in two cases, and also tumor cell infiltration to an intradural space and marked deformity of the spinal cord were seen in one case. These above findings would suggest that tumor cells, which metastasized to vertebral body through venous plexus from the primary lesion, infiltrated into the spinal canal, compressed spinal cord and caused paralysis.
对3例因脊柱转移性肿瘤导致完全性瘫痪并接受手术治疗的尸体解剖所获取的脊柱进行了放射学和组织学研究。这3例包括1例上颌癌转移至颈椎、1例精原细胞瘤转移至胸椎以及1例肾细胞癌转移至胸椎。尽管在出现完全性瘫痪后立即进行了肿瘤切除和脊柱融合术,但所有患者均未从瘫痪中恢复而死亡。对这些脊柱横断面的组织学检查显示,肿瘤细胞浸润至椎体和椎管,脊髓被肿瘤显著压迫。因此,在脊髓中可见不同程度的退变。此外,2例在椎体和椎管静脉中可见许多肿瘤细胞栓子,1例还可见肿瘤细胞浸润至硬膜内间隙以及脊髓明显变形。上述发现提示,肿瘤细胞从原发灶经静脉丛转移至椎体,浸润至椎管,压迫脊髓并导致瘫痪。