The first-ever clinical classification of metastatic spinal malignancies serves as a vital reference to surgical management:a retrospective case-control study

Abstract

Background: It is commonly accepted that Surgical treatment is an essential component of the comprehensive treatment of metastatic spinal malignancies. However, Up until now, the clinical classification of metastatic spinal malignancies has not been well-structured. Methods: After IRB approval, 86 patients with metastatic spinal malignancies who underwent therapy at the Second Hospital of Shanxi Medical University between January 2014 and March 2020 were adopted. According to the vascular distribution, stability of vertebrae and the degree of nerve compression, osteolytic metastatic spinal tumors can be classified into five types. 20 of them who did not receive segmental arterial embolization was set as a control group. The standard group included 24 patients who received segmental arterial embolization on both sides of the diseased vertebrae. 42 patients were included in the intervention group after receiving responsible arterial embolization. Surgical intervention was performed within 24 hours following an embolization. Results: In comparison with the control and standard groups, the intervention group presented unique advantages in terms of bleeding volume (p＜0.001), operating time (p＜0.001), and local recurrence rate within 12 months (p＜0.006). Conclusion: The promising surgical intervention strategies can be developed according to the new clinical classification of metastatic spinal malignancies.