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Related Experiment Video

Updated: Mar 17, 2026

Author Spotlight: Scope of LE-ULBD as a Safe, Effective, and Minimally Invasive Approach to Treat Lumbar Spinal Stenosis
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Decompression surgery for spinal metastases: a systematic review.

Dara Bakar1, Joseph E Tanenbaum2,3,4, Kevin Phan5,6

  • 1The Warren Alpert Medical School of Brown University, Providence, Rhode Island;

Neurosurgical Focus
|August 2, 2016
PubMed
Summary

This systematic review on decompression surgery for spinal metastases found good preoperative Karnofsky Performance Status (KPS) predicts survival. Preoperative ambulatory status significantly predicts postoperative ambulation, but time-to-surgery does not impact survival.

Keywords:
ASIA = American Spinal Injury AssociationECOG = Eastern Cooperative Oncology GroupEORTC = European Organisation for Research and Treatment of CancerEORTC QLQ-30 = Quality of Life questionnaireEORTC QLQ-BM22 = EORTC Bone Metastases moduleKPS = Karnofsky Performance StatusMESCC = metastatic epidural spinal cord compressionPRISMA = Preferred Reporting Items for Systematic Reviews and Meta-AnalysesPSA = prostate-specific antigenRR = risk ratioambulationdecompressionspinal cord compressionspinal metastasessurvival

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Area of Science:

  • Neurosurgery
  • Oncology
  • Orthopedic Surgery

Background:

  • Spinal metastases are a common complication of cancer.
  • Decompression surgery is a critical intervention for managing spinal metastases.
  • Outcomes and predictors following this surgery require systematic evaluation.

Purpose of the Study:

  • To systematically review reported outcomes of decompression surgery for spinal metastases.
  • To identify predictors of survival, neurological function, and ambulation.
  • To summarize complications and surgical techniques used.

Main Methods:

  • Systematic literature search of MEDLINE, Scopus, and Web of Science.
  • Inclusion of retrospective and prospective studies (1992-2015).
  • Categorization of outcomes: survival, ambulation, neurological function, surgical technique, complications, and primary tumor histology.

Main Results:

  • 36 studies (8 prospective, 28 retrospective) met inclusion criteria.
  • Good preoperative Karnofsky Performance Status (KPS ≥ 80%) predicted survival.
  • Preoperative ambulatory/motor status predicted postoperative ambulation; time-to-surgery did not affect survival.
  • Wound infection/dehiscence was the most common complication.
  • Common primary tumors: lung, prostate, breast, renal, GI cancers.

Conclusions:

  • Preoperative patient status is a significant predictor of outcomes after decompression surgery for spinal metastases.
  • Gaps in the literature necessitate future research into optimal surgical practices.
  • Findings can inform surgeons about established predictors for better patient management.