Clinical Outcomes and Safety of a Triple-Modality Approach Combining Decompression, Vertebral Augmentation, and...

Area of Science:

• Neurosurgery
• Oncology
• Orthopedic Surgery

Background:

• Thoracolumbar metastatic tumors with neurological injury present complex treatment challenges.
• Current treatments often involve conventional surgery, with varying degrees of success in managing pain and neurological deficits.

Purpose of the Study:

• To evaluate the clinical efficacy and safety of a triple-modality therapy (decompression, vertebral augmentation, radiotherapy) for thoracolumbar metastatic tumors with neurological injury.
• To compare outcomes of this novel therapy against conventional surgical methods.

Main Methods:

• Retrospective analysis of 86 patients with thoracolumbar metastatic tumors and neurological involvement.
• Intervention group (n=41) received triple-modality therapy; control group (n=45) received conventional surgery with fixation.
• Triple-modality therapy included decompression, bone cement-augmented vertebral augmentation and fixation, and stereotactic radiosurgery.

Main Results:

• The triple-modality group showed significantly reduced intraoperative blood loss despite longer surgical times.
• Both groups improved postoperatively, but the intervention group had significantly lower pain scores (VAS) and better Frankel grade and Karnofsky Performance Status scores.
• The control group experienced a significant increase in Cobb angle postoperatively, indicating instability.

Conclusions:

• The triple-modality therapy (decompression-vertebral augmentation-radiotherapy) is effective for thoracolumbar metastatic tumors with neurological injury.
• This approach alleviates pain, enhances neurological recovery, and improves quality of life.
• The therapy maintains spinal stability and exhibits a low complication rate.