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Survival after surgery for spinal metastatic disease: a nationwide multiregistry cohort study
Christian Carrwik1, Claes Olerud2, Yohan Robinson2,3,4
1Department of Surgical Sciences, Uppsala University, Uppsala, Sweden christian.carrwik@surgsci.uu.se.
Objectives:
To evaluate survival after surgery and indications for surgery due to spinal metastatic disease.
Design:
A retrospective longitudinal multiregistry nationwide cohort study.
Setting:
19 public hospitals in Sweden with spine surgery service, where 6 university hospitals account for over 90% of the cases.
Participants:
1820 patients 18 years or older undergoing surgery due to spinal metastatic disease 2006-2018 and registered in Swespine, the Swedish national spine surgery registry.
Interventions:
Decompressive and/or stabilising spine surgery due to spinal metastatic disease.
Primary Outcome:
Survival (median and mean) after surgery.
Secondary Outcomes:
Indications for surgery, types of surgery and causes of death.
Results:
The median estimated survival after surgery was 6.2 months (95% CI: 5.6 to 6.8) and the mean estimated survival time was 12.2 months (95% CI: 11.4 to 13.1). Neurologic deficit was the most common indication for surgery and posterior stabilisation was performed in 70.5% of the cases. A neoplasm was stated as the main cause of death for 97% of the patients.
Conclusion:
Both median and mean survival times were well above the generally accepted thresholds for surgical treatment for spinal metastases, suggesting that patient selection for surgical treatment on a national level is adequate. Further research on quality of life after surgery and prognostication is needed.
