Prognostic Factors of Surgical Complications and Overall Survival of Patients with Metastatic Spinal Tumor

Czigléczki, Gábor; Mezei, T; Pollner, Péter; Horváth, Anna; Banczerowski, Péter

doi:10.1016/j.wneu.2018.01.092

Cited by 13 publications

(8 citation statements)

References 31 publications

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“…Moreover it was independent from use of aid during walking such as cane or walker. This observation is consistent with the literature [17,20,23,24]. Additional maintaining ambulatory function may increased survival and quality of life [12,13,25].…”

Section: Discussionsupporting

confidence: 93%

“…Surgical treatment is indicated in patients with survival prognosis more than 6 mouth. Among patients with MESCC surgical treatment prove to be effective mainly with respect to pain reduction and improvements in the patient's functional status and quality of life [9,10,17].Numerous scoring systems have been developed to assess life expectancy and qualify patients for an appropriate treatment method. Wimberg et al assessed the 7 most popular scales used to select optimum therapy [18].…”

Section: Discussionmentioning

confidence: 99%

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Predictor of neurological function after surgical treatment of the metastatic epidural spinal cord compression

Adamski¹

2018

Chir. Narzadow Ruchu Ortop. Pol.

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Introduction. Postoperative neurological function influent prognosis and quality of life among patients with metastatic epidural spinal cord compression (MESCC). Aim. The aim of this study was to assess the predictor of postoperative neurological function in patients with MESCC, treated with spinal cord decompression. Materials and methods. The study analysed the medical records of 51 patients who underwent surgical treatment with corpectomy at the Department of Oncological Orthopaedics in Brzozów in 2014-2015. The majority of patients were male (61%). The mean age of patients was 61 years. Influence of following variable on postoperative neurological function were assessed: age, gender, location of primary tumor, location and number of affected segments, the pre-and early postoperative Frankel grade, ability to walk and use of walking aid. Variables were analyzed with univariate methods. Results. The majority of the patients were assigned to Frankel grade C. After surgical intervention 68 % of patients reagin ability to walk. Univariate analyses identify preoperative impairment scale grades, the ability to walk preoperatively, tumor localization, as predictors for neurological improvement and outcome. Conclusions. Early surgical decompression is essential to preserve neurological function, especially for patients with myeloma.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Predictor of neurological function after surgical treatment of the metastatic epidural spinal cord compression

Adamski¹

2018

Chir. Narzadow Ruchu Ortop. Pol.

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“…In our first report, we tested the factors that have the most significant impact on survival [14]. Later, we published about the efficiency and prediction accuracy of the four best-known scoring systems used with metastatic spinal tumor patients.…”

Section: Objective and Previous Resultsmentioning

confidence: 99%

Research on the predicting power of the revised Tokuhashi system: how much time can surgery give to patients with short life expectancy?

et al. 2020

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Object The primary treatment option for symptomatic metastatic spinal tumors is surgery. Prognostic systems are designed to assist in the establishment of the indication and the choice of surgical methodology. The best-known prognostic system is the revised Tokuhashi system, which has a predictive ability of about 60%. In our study, we are attempting to find the reason for its poor predictive ability, despite its proper separation ability. Methods We have designed a one-center-based retrospective clinical trial, by which we would like to test the feasibility and the inaccuracy of the revised Tokuhashi system. In our database, there are 329 patients who underwent surgery. Statistical analysis was performed. Results A significant increase in survival time was observed in the ‘conservative’ category. Earlier studies reported OS 0.15 at the 180-day control time, in contrast with our 0.38 OS value. The literature suggested supportive care for this category, but in our population, every patient underwent surgery. Our population passes the 0.15 OS value on day 475. We propose an adjustment of the Tokuhashi category scores. We observed significant success in resolving pain. Motor functions were improved or stabilized compared to changes in vegetative dysfunction. Conclusion According to our results, the Tokuhashi scoring system makes very conservative predictions and prefers non-surgical palliative or supportive care. Surgical treatment increases the life expectancy of patients in poor condition. We propose modifying the therapeutic options of the revised Tokuhashi system, taking into consideration modern spine surgery techniques.

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“…W ith the developments of the social economy and medical technology, the survival time of cancer patients is significantly prolonged 1 . The spine is the most common bone metastasis site in cancer patients 2 .…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Pedicle Screw Fixation Combined with Percutaneous Kyphoplasty Under O‐Arm Navigation for the Treatment of Metastatic Spinal Tumors with Posterior Wall Destruction

Zhou

Wang

Xiao

et al. 2020

Orthopaedic Surgery

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Objective To evaluate the safety and efficacy of O‐arm‐guided minimally invasive pedicle screw fixation combined with percutaneous kyphoplasty for metastatic spinal tumors with posterior wall destruction. Methods Patients who underwent minimally invasive pedicle screw fixation combined with percutaneous kyphoplasty for pathological vertebral fractures with posterior wall defects from January 2015 to December 2017 were followed up for 1 year. Visual analogue scale (VAS), SF‐36 scores, middle vertebral height, posterior vertebral height, and the accuracy of pedicle screws were assessed preoperatively, postoperatively, and 1 year after surgery. The operation time, time from operation to discharge, blood loss, volume of bone cement, and leakage of bone cement were recorded. Results Twenty‐three patients (13 females and 10 males) who met our criteria were followed up for 1 year. The operation time of these patients was 162.61 ± 33.47 min, the amount of bleeding was 230.87 ± 93.76 mL, the time from operation to discharge was 4.35 ± 2.42 days, and the volume of bone cement was 3.67 ± 0.63 mL. The VAS score decreased from 7.04 ± 1.07 to 2.65 ± 0.93 before surgery (P = 0.000) and remained at 2.57 ± 0.79 1 year after surgery. Compared with the preoperative SF‐36 scores for physical pain, physiological function, energy, and social function, the postoperative scores were significantly improved (P = 0.000). The height of the middle vertebral body increased from 14.47 ± 2.96 mm before surgery to 20.18 ± 2.94 mm (P = 0.000), and remained at 20.44 to 3.01 mm 1 year after surgery. The height of the posterior vertebral body increased from 16.56 ± 3.07 mm before operation to 22.79 ± 4.00 mm (P = 0.000), and 22.45 ± 3.88 mm 1 year after surgery. The 23 patients had a total of 92 pedicle screws; 85 screws were Grade A and 7 screws were Grade B. There was no leakage of bone cement after surgery. Conclusion In the short term, O‐arm‐guided minimally invasive pedicle screw fixation combined with kyphoplasty is safe and effective in the treatment of metastatic spinal tumors with posterior wall destruction.

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Prognostic Factors of Surgical Complications and Overall Survival of Patients with Metastatic Spinal Tumor

Cited by 13 publications

References 31 publications

Predictor of neurological function after surgical treatment of the metastatic epidural spinal cord compression

Predictor of neurological function after surgical treatment of the metastatic epidural spinal cord compression

Research on the predicting power of the revised Tokuhashi system: how much time can surgery give to patients with short life expectancy?

Minimally Invasive Pedicle Screw Fixation Combined with Percutaneous Kyphoplasty Under O‐Arm Navigation for the Treatment of Metastatic Spinal Tumors with Posterior Wall Destruction

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