Conventional Radiotherapy Timing and Wound Complication Avoidance After Surgery for Metastatic Spine Disease. A LatAm...

Area of Science:

• Oncology
• Neurosurgery
• Radiation Oncology

Background:

• Surgery and radiotherapy are standard for spinal metastases requiring stabilization or decompression.
• Optimal timing of radiotherapy post-surgery is critical for balancing treatment effectiveness and minimizing wound complications.
• This study explored Latin American spinal surgeons' consensus on conventional external beam radiotherapy (cEBRT) after spinal surgery for metastases, focusing on wound complication risks.

Purpose of the Study:

• To identify consensus and non-consensus areas among Latin American spinal surgeons regarding cEBRT use, timing, risks, and surgical approach post-metastasis surgery.
• Specifically focused on understanding the risk of radiotherapy-related wound complications.

Main Methods:

• A modified Delphi survey methodology was employed.
• The expert panel comprised active members of AOSpine Latin America with significant experience in vertebral metastasis surgery.
• The survey included 37 statements, with consensus levels defined as weak (70-79.9%), moderate (80-89.9%), and strong (≥90%).

Main Results:

• Consensus (≥70%) was achieved on 32 out of 37 statements (86.5%).
• Strong agreement was noted on the importance of poor nutrition as a risk factor for cEBRT-related wound complications.
• Posterior midline surgical approaches and junctional/sacral spine locations were associated with higher perceived wound complication risks.

Conclusions:

• Strong expert agreement exists on critical aspects like waiting times and risk factors for cEBRT.
• Clinical decisions should carefully consider spinal levels, surgical approaches, and suture techniques.
• These findings provide valuable insights for optimizing combined treatment protocols for spinal metastases.