脊柱杂志

Outcome of Palliative Single Posterior Reconstruction Surgery for Metastatic Spinal Tumor

Abstract

Shingo Miyazaki, Hiroshi Miyamoto, Koki Uno and Masatoshi Sumi

Study design: A retrospective single-center study

Objective: To report the clinical and radiological outcomes of palliative single posterior reconstruction surgery for the treatment of metastatic spinal tumor in different regions of the spine.

Summary of background data: The indications of surgical procedures, whether anterior, posterior or a combination of these, for patient with metastatic spinal tumor are still controversial, and all procedures have their pros and cons.

Methods: A retrospective analysis involving 53 patients (34 male, 19 female, 66.4 ± 9.8 years old) who underwent palliative single posterior reconstruction surgery for metastatic spinal tumor. 10 patients were affected in the cervical region (C2-7), 27 in the thoracic region (Th1-10), and 16 in the thoracolumbar/lumbosacral region (Th11-L5). Common primary tumors were prostate, lung, and thyroid cancers. Clinical evaluation of pain level, neurological function, ambulatory ability, and complications was carried out for the different sites, and correction angle and loss of correction were evaluated radiologically.

Results: 86% of the patients experienced pain relief, 70% improved by one or more Frankel grades, and 75% became ambulatory at follow-up, regardless of the affected region. The cervical group demonstrated a significantly greater correction angle (8.00 ± 4.84 degrees) compared to other groups (thoracic: 3.42 ± 4.97 degrees, thoracolumbar/ lumbosacral: 3.62 ± 4.31 degrees) and also exhibited a smaller loss of correction (0.33 ± 3.31 degrees) compared to other groups (thoracic: 2.80 ± 2.46 degrees, thoracolumbar/lumbosacral: 2.85 ± 3.10 degrees).

Conclusion: Palliative single posterior reconstruction surgery provided good clinical and radiological outcomes at any region. Therefore, this procedure can be a choice of surgical treatment for metastatic spinal tumor, because of its lower invasiveness, for immunocompromised cancer patients.