Epidemiologic Study of Operative Treatment for Spinal Metastasis in Thailand : A Review of National Healthcare Data from 2005 to 2014

Abstract

Objective : To study the factors relating to operative treatment for spinal metastasis in Thailand during 2005–2014 and to determine the hospital costs, mortality rate, and incidence of perioperative complication.Methods : Inpatient reimbursement data from 2005 to 2014 was reviewed from three national healthcare organizations, including the National Health Security Office, the Social Security Office, and the Comptroller General’s Department. The search criteria were secondary malignant neoplasm of bone and bone marrow patients (International Classification of Diseases 10th revision, Thai modification codes [ICD 10-TM], C79.5 and C79.8) who underwent spinal surgical treatment (ICD 9th revision, clinical modification procedure with extension codes [ICD 9-CM], 03.0, 03.4, 03.09, and 81.0) during 2005–2014. Epidemiology, comorbidity, and perioperative complication were analyzed.Results : During the study period, the number of spinal metastasis patients who underwent operative treatment was significantly increased from 0.30 to 0.59 per 100000 (p<0.001). More males (56.14%) underwent surgical treatment for spinal metastasis than females. The most common age group was 45–64 (55.1%). The most common primary tumor sites were the unknown origin, lung, breast, prostate, and hepatocellular/bile duct. Interestingly, the proportion of hepatocellular/bile duct, breast, and lung cancer was significantly increased (p<0.001). The number of patients who had comorbidity or in-hospital complication significantly increased over time (p<0.01); however, the in-hospital mortality rate decreased.Conclusion : During the last decade, operative treatment for spinal metastasis increased in Thailand. The overall in-hospital complication rate increased; however, the in-hospital mortality rate decreased.

The Role and Clinical Outcomes of Endoscopic Spine Surgery of Treating Spinal Metastases; Outcomes of 29 Cases From 8 Countries

“…Although all have revealed good results of rapid pain relief, neurological recovery, less blood loss, and the reduction of LOS, the level of evidence is considered low as they are all case reports or series with an insufficient number of patients ( Supplementary Table 2 ). This could also be from the lower incidence of symptomatic spinal metastases undergone surgery compared to other general spinal diseases [ 35 , 36 ]. Therefore, less number of cases and fewer adoption of endoscopic spine surgery used in spinal metastases is expected.…”

“…This could also be from the lower incidence of symptomatic spinal metastases undergone surgery compared to other general spinal diseases. 35,36 Therefore, less number of cases and fewer adoption of endoscopic spine surgery used in spinal metastases is expected. To overcome this, a worldwide collaboration of spine surgeons is established by our senior author (KJS).…”

Hematologic Malignancies Influence the Accuracy of Prediction of Survival in Patients With Solid Tumor Spinal Metastases Undergoing Surgery

“…1,2 As the duration of survival has improved markedly with advances in therapy, the incidence of spinal metastasis has been increasing. [3][4][5][6][7] In addition, with the development of new spinal surgery procedures, surgical outcomes are promising, even in patients with long-or multiple-level spinal metastases. [7][8][9][10] accurate at predicting the survival of patients with spinal metastasis undergoing surgery.…”

Risk Factors for Poor Outcome after Palliative Surgery for Metastatic Spinal Tumors

“…Palliative surgery is an effective treatment for improving patients' ADL and QOL. After Patchell's report, which proved the efficacy of palliative surgery over radiation therapy [4], the number of surgeries have increased over time with the development of surgical methods and instruments [5,6]. Percutaneous vertebroplasty (VP)/balloon kyphoplasty (BKP) [7], decompression [8], spinal instrumentation [9], and a combination of these methods, with or without tumor resection [10,11], are standard options for palliative surgery.…”