Title: Low Backache – Profile of Oncological Patients
Authors: Arvind Kumar, Usha Singh
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.150
Abstract
Back pain is one of the most common complaints which brings patients to physician. Spine is one of the most common site for metastasis. The most common primary tumor in patients with metastasis are breast, lung, prostate and kidney.
This study aimed to evaluate patients profile for low backache in different types of malignancy.
Material and Methods: Total 50 patients of histopathologically proven different malignancy were retrospectively analysed for low backache during 2014 to 2016. Cases included were both metastatic bone disease in vertebrae, pelvic bone, proximal femur and primary tumors of spine.
Results: 46% of the patients were in age range of 50-69 years followed by 40% patients in age range of 30-49 years. Incidence of male were 18(36%) patients and female were 32(64%). 35(70%) patients were not addicted,9(18%) were addicted to tobacco alone,4(8%) patients were addicted to smoking alone, various others are addicted in combination. 47(94%) were metastatic bone disease, 3(6%) patients were primary wings sarcoma of spine. Majority of the patients were of breast cancer 20(40%), gynaecological cancer 8(16%), multiple myeloma and head and neck cancer each 6(12%) patients. Prostate cancer 4(8%), lung cancer 2(4%), renal cell cancer 1(2%) patient. Bony metastasis most common site were vertebra 16(32%), pelvis 12(24%), proximal femur 4(8%) cases. In combination group vertebra with pelvis 12(24%), vertebra with proximal femur 3(6%), proximal femur with pelvis 2(4%).
Bony metastasis in 19(38%) patients cases was associated with spinal mas, In 11(22%) patients mass was pressing spinal nerve roots, in 8(16%) patients causing compression of spinal cord. 7(14%) patients had pathological fracture.
Conclusion: pain caused by spinal metastasis is typically persistent and progressive not relieved by rest.Metastases may present as mechanical pain, radicular pain or weakness, or with myelopathy. Management of back pain in metastatic bone metastasis involve combination of pain based on specific patients, prognosis, neurological status, age, primary histopathology.
Keywords: Backache, metastatic bone disease, spine, vertebra.
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