Clinical Outcome of Single-Stage Posterior Decompression and Stabilisation for Spine Metastasis
Introduction: Surgical treatment for indicated spinal metastases cases is an option to improve patients’ outcomes. Local data in analysing the potential of patients’ improvement after surgical treatment are limited. We intend to review the clinical outcomes of surgeries performed for cancer patients...
Saved in:
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Malaysian Orthopaedic Association
2024-11-01
|
| Series: | Malaysian Orthopaedic Journal |
| Subjects: | |
| Online Access: | https://www.morthoj.org/2024/v18n3/spine-metastases.pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850169494642622464 |
|---|---|
| author | Wang CS Atan Z |
| author_facet | Wang CS Atan Z |
| author_sort | Wang CS |
| collection | DOAJ |
| description | Introduction: Surgical treatment for indicated spinal metastases cases is an option to improve patients’ outcomes. Local data in analysing the potential of patients’ improvement after surgical treatment are limited. We intend to review the clinical outcomes of surgeries performed for cancer patients who were diagnosed with spinal metastases. We aim to identify factors associated with improved spinal pain, neurological deficit and patient survival.
Materials and methods: The medical records of 51 patients who were diagnosed with thoracolumbar spinal metastatic tumour and underwent palliative single-stage posterior approach spinal surgery between June 2015 and June 2022 were recruited retrospectively. Patient demographic data, pre-operative and post-operative pain scores, neurological assessment and survival duration were collected from the medical records. Radiological findings were studied using respective imaging and reports.
Results: The mean age was 57.5 years, and the median survival was nine months after the surgical treatment. The post-operative pain improvements were statistically significant at two weeks (VAS improved from 5 to 2), and three months follow-up VAS was one (p<0.001 and p=0.009, respectively). At initial presentation, patients with a single-level spinal involvement had higher VAS compared to multiple spinal metastases (p=0.018). A total of 18 (35.3%) patients had improved one or more ASIA grades, of which eight (15.7%) of them had gain of ambulatory function (p<0.001). Twenty-seven (52.9%) patients were ambulatory post-operative. The slow growth type of primary carcinoma, post-operative ambulatory ability, and the absence of perioperative morbidity were factors associated with favourable survival duration (p=0.006, p<0.001 and p<0.001, respectively). Synchronous visceral metastases adversely affected the survival duration (p=0.008).
Conclusions: Single-stage posterior decompression and stabilisation improved the clinical outcomes of spinal pain and neurological deficit in metastatic spinal tumours. Type of primary tumour, visceral metastasis, perioperative morbidity, and post-operative ambulatory status significantly impact post-operative survival duration. |
| format | Article |
| id | doaj-art-167576046ef84afcbeb6e2f320786fa0 |
| institution | OA Journals |
| issn | 1985-2533 2232-111X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Malaysian Orthopaedic Association |
| record_format | Article |
| series | Malaysian Orthopaedic Journal |
| spelling | doaj-art-167576046ef84afcbeb6e2f320786fa02025-08-20T02:20:42ZengMalaysian Orthopaedic AssociationMalaysian Orthopaedic Journal1985-25332232-111X2024-11-0118311010.5704/MOJ.2411.005Clinical Outcome of Single-Stage Posterior Decompression and Stabilisation for Spine MetastasisWang CS0Atan Z1Department of Orthopaedics, Hospital Raja Permaisuri Bainun, Ipoh, MalaysiaDepartment of Orthopaedics, Hospital Raja Permaisuri Bainun, Ipoh, MalaysiaIntroduction: Surgical treatment for indicated spinal metastases cases is an option to improve patients’ outcomes. Local data in analysing the potential of patients’ improvement after surgical treatment are limited. We intend to review the clinical outcomes of surgeries performed for cancer patients who were diagnosed with spinal metastases. We aim to identify factors associated with improved spinal pain, neurological deficit and patient survival. Materials and methods: The medical records of 51 patients who were diagnosed with thoracolumbar spinal metastatic tumour and underwent palliative single-stage posterior approach spinal surgery between June 2015 and June 2022 were recruited retrospectively. Patient demographic data, pre-operative and post-operative pain scores, neurological assessment and survival duration were collected from the medical records. Radiological findings were studied using respective imaging and reports. Results: The mean age was 57.5 years, and the median survival was nine months after the surgical treatment. The post-operative pain improvements were statistically significant at two weeks (VAS improved from 5 to 2), and three months follow-up VAS was one (p<0.001 and p=0.009, respectively). At initial presentation, patients with a single-level spinal involvement had higher VAS compared to multiple spinal metastases (p=0.018). A total of 18 (35.3%) patients had improved one or more ASIA grades, of which eight (15.7%) of them had gain of ambulatory function (p<0.001). Twenty-seven (52.9%) patients were ambulatory post-operative. The slow growth type of primary carcinoma, post-operative ambulatory ability, and the absence of perioperative morbidity were factors associated with favourable survival duration (p=0.006, p<0.001 and p<0.001, respectively). Synchronous visceral metastases adversely affected the survival duration (p=0.008). Conclusions: Single-stage posterior decompression and stabilisation improved the clinical outcomes of spinal pain and neurological deficit in metastatic spinal tumours. Type of primary tumour, visceral metastasis, perioperative morbidity, and post-operative ambulatory status significantly impact post-operative survival duration.https://www.morthoj.org/2024/v18n3/spine-metastases.pdfspine metastasessurgical decompressionposterior spinal stabilisationclinical outcome |
| spellingShingle | Wang CS Atan Z Clinical Outcome of Single-Stage Posterior Decompression and Stabilisation for Spine Metastasis Malaysian Orthopaedic Journal spine metastases surgical decompression posterior spinal stabilisation clinical outcome |
| title | Clinical Outcome of Single-Stage Posterior Decompression and Stabilisation for Spine Metastasis |
| title_full | Clinical Outcome of Single-Stage Posterior Decompression and Stabilisation for Spine Metastasis |
| title_fullStr | Clinical Outcome of Single-Stage Posterior Decompression and Stabilisation for Spine Metastasis |
| title_full_unstemmed | Clinical Outcome of Single-Stage Posterior Decompression and Stabilisation for Spine Metastasis |
| title_short | Clinical Outcome of Single-Stage Posterior Decompression and Stabilisation for Spine Metastasis |
| title_sort | clinical outcome of single stage posterior decompression and stabilisation for spine metastasis |
| topic | spine metastases surgical decompression posterior spinal stabilisation clinical outcome |
| url | https://www.morthoj.org/2024/v18n3/spine-metastases.pdf |
| work_keys_str_mv | AT wangcs clinicaloutcomeofsinglestageposteriordecompressionandstabilisationforspinemetastasis AT atanz clinicaloutcomeofsinglestageposteriordecompressionandstabilisationforspinemetastasis |