Radiotherapy after surgery for spinal metastasis is associated with superior neurological improvement as compared to surgery alone

Introduction: Treatment of spinal metastases is multidisciplinary, where radiotherapy (RT) and surgery have a central role. The effect of adjuvant post-operative RT versus surgery alone for metastatic spinal disease has not been previously investigated. Our aim was to analyze whether post-operative...

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Main Authors: Kontakis Michael G., Ehne Jessica, Svahn-Karahan Sayam, Tsagkozis Panagiotis
Format: Article
Language:English
Published: EDP Sciences 2025-01-01
Series:SICOT-J
Subjects:
Online Access:https://www.sicot-j.org/articles/sicotj/full_html/2025/01/sicotj250031/sicotj250031.html
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author Kontakis Michael G.
Ehne Jessica
Svahn-Karahan Sayam
Tsagkozis Panagiotis
author_facet Kontakis Michael G.
Ehne Jessica
Svahn-Karahan Sayam
Tsagkozis Panagiotis
author_sort Kontakis Michael G.
collection DOAJ
description Introduction: Treatment of spinal metastases is multidisciplinary, where radiotherapy (RT) and surgery have a central role. The effect of adjuvant post-operative RT versus surgery alone for metastatic spinal disease has not been previously investigated. Our aim was to analyze whether post-operative RT was associated with better functional outcome or increased incidence of local complications after surgical treatment for spinal metastatic disease. Methods: Information on neurologic outcome of 200 patients surgically treated for spinal metastases was retrieved from the institutional registry. The events of pre-operative and post-operative neurological function, post-operative wound complications as well as death and implant revision were available. Results: Post-operative RT was significantly associated to superior neurological recovery, evaluated both as restoration of the ambulatory capacity and absolute change in the Frankel score. At the same time, use of post-operative RT was not associated to an increased risk of wound complications. The risk for revision surgery when RT was administered was similar to surgery alone in a competing risks analysis with death as the competing event. Discussion: The results indicate that surgery with post-operative RT is associated with superior neurologic recovery than surgery alone. The results also do not indicate any significant risk for wound healing problems with administered post-operative RT.
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institution Kabale University
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publishDate 2025-01-01
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spelling doaj-art-b1562b0b60ff4becb1fa91a7ac6dddc62025-08-20T03:53:47ZengEDP SciencesSICOT-J2426-88872025-01-01112810.1051/sicotj/2025026sicotj250031Radiotherapy after surgery for spinal metastasis is associated with superior neurological improvement as compared to surgery aloneKontakis Michael G.0Ehne Jessica1Svahn-Karahan Sayam2Tsagkozis Panagiotis3Department of Surgical Sciences, Orthopaedics, Uppsala UniversityDepartment of Molecular Medicine and Surgery, Karolinska InstituteDepartment of Molecular Medicine and Surgery, Karolinska InstituteDepartment of Molecular Medicine and Surgery, Karolinska InstituteIntroduction: Treatment of spinal metastases is multidisciplinary, where radiotherapy (RT) and surgery have a central role. The effect of adjuvant post-operative RT versus surgery alone for metastatic spinal disease has not been previously investigated. Our aim was to analyze whether post-operative RT was associated with better functional outcome or increased incidence of local complications after surgical treatment for spinal metastatic disease. Methods: Information on neurologic outcome of 200 patients surgically treated for spinal metastases was retrieved from the institutional registry. The events of pre-operative and post-operative neurological function, post-operative wound complications as well as death and implant revision were available. Results: Post-operative RT was significantly associated to superior neurological recovery, evaluated both as restoration of the ambulatory capacity and absolute change in the Frankel score. At the same time, use of post-operative RT was not associated to an increased risk of wound complications. The risk for revision surgery when RT was administered was similar to surgery alone in a competing risks analysis with death as the competing event. Discussion: The results indicate that surgery with post-operative RT is associated with superior neurologic recovery than surgery alone. The results also do not indicate any significant risk for wound healing problems with administered post-operative RT.https://www.sicot-j.org/articles/sicotj/full_html/2025/01/sicotj250031/sicotj250031.htmlspinemetastasissurgeryradiotherapyrecovery
spellingShingle Kontakis Michael G.
Ehne Jessica
Svahn-Karahan Sayam
Tsagkozis Panagiotis
Radiotherapy after surgery for spinal metastasis is associated with superior neurological improvement as compared to surgery alone
SICOT-J
spine
metastasis
surgery
radiotherapy
recovery
title Radiotherapy after surgery for spinal metastasis is associated with superior neurological improvement as compared to surgery alone
title_full Radiotherapy after surgery for spinal metastasis is associated with superior neurological improvement as compared to surgery alone
title_fullStr Radiotherapy after surgery for spinal metastasis is associated with superior neurological improvement as compared to surgery alone
title_full_unstemmed Radiotherapy after surgery for spinal metastasis is associated with superior neurological improvement as compared to surgery alone
title_short Radiotherapy after surgery for spinal metastasis is associated with superior neurological improvement as compared to surgery alone
title_sort radiotherapy after surgery for spinal metastasis is associated with superior neurological improvement as compared to surgery alone
topic spine
metastasis
surgery
radiotherapy
recovery
url https://www.sicot-j.org/articles/sicotj/full_html/2025/01/sicotj250031/sicotj250031.html
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AT ehnejessica radiotherapyaftersurgeryforspinalmetastasisisassociatedwithsuperiorneurologicalimprovementascomparedtosurgeryalone
AT svahnkarahansayam radiotherapyaftersurgeryforspinalmetastasisisassociatedwithsuperiorneurologicalimprovementascomparedtosurgeryalone
AT tsagkozispanagiotis radiotherapyaftersurgeryforspinalmetastasisisassociatedwithsuperiorneurologicalimprovementascomparedtosurgeryalone