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Comprehensive surgical treatment strategy for spinal metastases
Arthur Wagner1, Elena Haag2, Ann-Kathrin Joerger2
1Department of Neurosurgery, Klinikum Rechts Der Isar, Technical University Munich School of Medicine, Ismaninger Str. 22, 81675, Munich, Germany. arthur.wagner@tum.de.
Scientific Reports
|April 13, 2021
Summary
Surgical management of spinal metastases (SM) is crucial for patient outcomes. This study highlights surgery as a primary treatment step, improving functional status and survival for cancer patients with bone lesions.
Area of Science:
- Oncology
- Neurosurgery
- Orthopedic Surgery
Background:
- Spinal metastases (SM) necessitate multidisciplinary oncological care.
- Surgical management of SM has advanced, requiring reassessment of its role.
- Optimal treatment strategies for SM are continuously evolving.
Purpose of the Study:
- To evaluate the role of surgical intervention in managing spinal metastases.
- To analyze baseline characteristics, surgical procedures, complications, and outcomes in a large cohort of SM patients.
- To assess the impact of surgical treatment on functional status and overall survival.
Main Methods:
- Retrospective analysis of 667 patients undergoing 989 surgeries for spinal metastases between 2007 and 2018.
- Data collection included patient demographics, primary cancer origin, surgical techniques (stabilization, decompression, kyphoplasty), complication rates, and functional status (Karnofsky Performance Status - KPS).
- Survival analysis was performed to determine overall survival rates.
Main Results:
- The cohort's mean age was 65 years, with common primary cancers including prostate (21.7%), breast (15.9%), and lung (10.0%).
- Surgical procedures comprised dorsoventral stabilization (69.5%), decompression (12.5%), and kyphoplasty (18.0%).
- Overall survival was 18.4 months, and median KPS improved by 10 points during hospitalization.
Conclusions:
- Surgical management should be considered a primary component of a comprehensive treatment algorithm for spinal metastases.
- Current surgical strategies aim to preserve long-term symptom control and biomechanical stability.
- Further research, including Level I evidence, is needed to fully support existing surgical strategies for SM.
