Single-stage posterior decompression and stabilization for metastasis of the thoracic spine: prognostic factors for functional outcome and patients' survival

• Published in: The spine journal 2012-12, Vol.12 (12), p.1083-1092
• Main Authors: Chong, Sangjoon, MD, Shin, Sang-Hoon, MD, Yoo, Heon, MD, PhD, Lee, Seung Hoon, MD, PhD, Kim, Ki-Jeong, MD, PhD, Jahng, Tae-Ahn, MD, PhD, Gwak, Ho-Shin, MD, PhD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Databases, Factual; Decompression, Surgical - methods; Decompression, Surgical - mortality; Female; Humans; Male; Metastasis; Middle Aged; Orthopedics; Pain - pathology; Pain - surgery; Pain Measurement; Postoperative Period; Prognosis; Retrospective Studies; Spinal Cord Compression - mortality; Spinal Cord Compression - pathology; Spinal Cord Compression - surgery; Spinal Neoplasms - mortality; Spinal Neoplasms - secondary; Spinal Neoplasms - surgery; Surgical decompression; Survival; Thoracic vertebrae; Thoracic Vertebrae - pathology; Thoracic Vertebrae - surgery; Treatment Outcome
• ISSN: 1529-9430; 1878-1632
• DOI: 10.1016/j.spinee.2012.10.015

Abstract Background context There are limited data analyzing radiological and clinical factors for the functional outcomes of surgery for spinal metastasis. Also, there are few studies to investigate the relationship between the functional outcome and the patients' survival. Thus, analysis of both functional outcomes and the survival with their relationship in a possibly homogenous group of patients is worth being reported. Purpose To assess treatment outcomes of single-stage posterior decompression and stabilization (PDS) with or without corpectomy for thoracic vertebral metastases and to analyze factors affecting both the functional outcome and the patients' survival after the surgical intervention. Study design Retrospective observational study. Patient sample A consecutive series of 105 patients, who underwent the previously stated surgery for metastatic spinal cord compression (MSCC) of thoracic spine, were included and retrospectively analyzed. Outcome measures The postoperative functional outcomes were evaluated using visual analog scale and Frankel grade at postoperative 2 weeks, and all patients were followed for survival analysis. Methods An institutional database was searched to identify all patients who underwent single-stage PDS for thoracic metastatic spinal tumors between March 2002 and June 2010. Demographic data as well as preoperative and postoperative medical conditions were collected from medical records. Radiological findings were confirmed on electronic archive. Survival data were obtained either on medical records or with a reference to governmental cancer registry system. Results Postoperative pain improvement was more evident in patients receiving anterior column reconstruction and four or more levels of fixation (p=.02 and