Thyroid cancer spinal metastases: report on 25 operations in 14 patients.

This study reviewed 14 patients with thyroid cancer spinal metastases treated between December 1984 and July 2000. In total the 14 patients had undergone 25 operations (average 1.8 operations/patient). The operations were at the thoracic (15), cervical (7) and lumbar (3) levels and operations included piecemeal excision (14), total en bloc spondylectomy (7), posterior decompression and stabilization (2), posterior decompression (laminectomy) (1) and posterior stabilization (1). Re-operations were due to local recurrence (8) or metastases to another level (2) or both (1). One patient died in the third postoperative day due to disseminated intravascular coagulopathy (DIC), 5 died due to the original illness after a mean of 67.8 months, while 8 patients are still living after a mean of 53.1 months. As long survival should be anticipated, in cases of thyroid cancer spinal metastases, a radical therapeutic attitude must be considered in decision-making. This should avoid the morbidity associated with local recurrence and revision surgery.