Based on the analysis of modern literature, surgical approaches to the treatment of chronic pain syndrome in cancer patients are presented. The definition and classification of chronic pain syndrome is given, its pathophysiology is described. The frequency of occurrence in the population and its dependence on the stage and localization of malignant neoplasm is shown. For practical use, an algorithm for the diagnosis of chronic pain syndrome and the basic principles of its therapy are presented. As the 4th step of the World Health Organization pain relief ladder, surgical methods for the treatment of chronic pain syndrome are separately considered. Three main types of surgical interventions (neuromodulating, neurodestructive and anatomical) are described, indications and contraindications to their use are indicated.

Malignant neoplasms remain the leading cause of death worldwide. The spine is a target for metastasis more often than other skeletal bones. This article details the principles of diagnosis, treatment, and the clinical picture of secondarylesions of the spinal column. The causes of pain syndrome in cancerous lesions of the spine are reviewed: compression of nerve structures, pathological fractures, spinal instability, lytic foci and paraneoplastic pain syndrome. The causes and patterns of each type of pain syndrome are described in detail. The article presents the scales used to predict the life expectancy of these patients: Tokuhashi, Tomita and Bauer. The effectiveness of these scales is compared. The selection criteria for surgical treatment of patients with metastatic lesions of the spine are described in detail. Modern methods of surgical treatment of secondary lesions of the spinal column are presented: palliative, subtotal, total (enblock resections). The indications and contraindications for each type of surgical treatment are described. Methods of intraoperative hemostasis are described, with the special attention given to preoperative tumor embolization. The errors and complications of this technique are described in detail. The correlation dependence of intraoperative blood loss volume on the embolization terms is presented. Modern trends in the development of surgical methods in metastatic spinal tumors are described in conclusion.

Наиболее часто опухоли спинного мозга (СМ) наблюдаются в социально активной группе людей в возрасте 30-50 лет с преобладанием экстрамедуллярных опухолей, что определяет большую актуальность указанной проблемы. Представлен анализ данных современной литературы, посвященной основным методам диагностики опухолей СМ. Отражены возможности применения компьютерной томографии, магнитно-резонансной томографии (МРТ), диффузионно-взвешенной МРТ. Представлены разные хирургические методы лечения экстрамедуллярных опухолей СМ, особая роль уделена малоинвазивным подходам. Описаны осложнения послеоперационных вмешательств. Отмечено, что радикальность хирургического лечения опухолей СМ зависит не только от локализации и размеров опухоли, но и от ее гистологической структуры, что определяет исход...

Tumors of the spinal cord include several nosological units and are classified depending on their location and histological type. The article presents the general characteristics, classification, and epidemiology of spinal cord tumors. The paper presents the clinical manifestations of intradural extramedullary tumors of the spinal cord. The main methods of diagnosing extramedullary tumors of the spinal cord are highlighted. Furthermore, the paper details the modern aspects of the surgical treatment of spinal cord tumors. Particular emphasis is placed on the complications of surgical interventions. The radicality of neurosurgical treatment of spinal cord tumors depends not only on the location and size of the tumor, but also on its histological structure, which determines the outcome of the disease.