Spinal metastasis with neurologic deficits: Outcome of late surgery in patients primarily deemed not suitable for surgery
Background and purpose — A significant number of patients with spinal metastases are treated non-surgically, but may need surgical treatment at a later stage due to progression of symptoms. Therefore, we investigated the need for late surgical decompression in patients with spinal metastasis who wer...
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2018-03-01
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| Series: | Acta Orthopaedica |
| Online Access: | http://dx.doi.org/10.1080/17453674.2017.1412193 |
| _version_ | 1798017970618761216 |
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| author | Panagiotis Tsagozis Henrik C F Bauer |
| author_facet | Panagiotis Tsagozis Henrik C F Bauer |
| author_sort | Panagiotis Tsagozis |
| collection | DOAJ |
| description | Background and purpose — A significant number of patients with spinal metastases are treated non-surgically, but may need surgical treatment at a later stage due to progression of symptoms. Therefore, we investigated the need for late surgical decompression in patients with spinal metastasis who were initially deemed as non-surgical candidates, as well as the outcome of late surgery. Patients and methods — 116 patients who were referred to the orthopedic oncology department between 2002 and 2011 due to spinal metastasis with neurologic symptoms were deemed to be non-surgical candidates. The primary reason was minor neurologic deficits in 40 patients (M) and short survival (S) in 76 patients. Results — 8 patients underwent a late operation due to progression of the neurologic symptoms, all of them belonged to group M. M-patients with a modified Bauer score of less than 2 had both an inferior survival as well as a higher risk for late surgery. Postoperative improvement in neurologic function was noted in 5/8 operated patients, whilst 2 patients had stationary symptoms and 1 deteriorated. Interpretation — The need for late surgery arises in a minority of patients with spinal metastasis primarily treated non-surgically, and only in patients with minor neurologic compromise rather than poor general condition. An established prognostic score (modified Bauer) can be used to guide decision-making. Late surgical decompression is effective in restoring the neurologic status |
| first_indexed | 2024-04-11T16:16:17Z |
| format | Article |
| id | doaj.art-348cbdff38fb44bc90cc20b61e4a2c1d |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-04-11T16:16:17Z |
| publishDate | 2018-03-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-348cbdff38fb44bc90cc20b61e4a2c1d2022-12-22T04:14:31ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822018-03-0189222923310.1080/17453674.2017.14121931412193Spinal metastasis with neurologic deficits: Outcome of late surgery in patients primarily deemed not suitable for surgeryPanagiotis Tsagozis0Henrik C F Bauer1Karolinska InstituteKarolinska InstituteBackground and purpose — A significant number of patients with spinal metastases are treated non-surgically, but may need surgical treatment at a later stage due to progression of symptoms. Therefore, we investigated the need for late surgical decompression in patients with spinal metastasis who were initially deemed as non-surgical candidates, as well as the outcome of late surgery. Patients and methods — 116 patients who were referred to the orthopedic oncology department between 2002 and 2011 due to spinal metastasis with neurologic symptoms were deemed to be non-surgical candidates. The primary reason was minor neurologic deficits in 40 patients (M) and short survival (S) in 76 patients. Results — 8 patients underwent a late operation due to progression of the neurologic symptoms, all of them belonged to group M. M-patients with a modified Bauer score of less than 2 had both an inferior survival as well as a higher risk for late surgery. Postoperative improvement in neurologic function was noted in 5/8 operated patients, whilst 2 patients had stationary symptoms and 1 deteriorated. Interpretation — The need for late surgery arises in a minority of patients with spinal metastasis primarily treated non-surgically, and only in patients with minor neurologic compromise rather than poor general condition. An established prognostic score (modified Bauer) can be used to guide decision-making. Late surgical decompression is effective in restoring the neurologic statushttp://dx.doi.org/10.1080/17453674.2017.1412193 |
| spellingShingle | Panagiotis Tsagozis Henrik C F Bauer Spinal metastasis with neurologic deficits: Outcome of late surgery in patients primarily deemed not suitable for surgery Acta Orthopaedica |
| title | Spinal metastasis with neurologic deficits: Outcome of late surgery in patients primarily deemed not suitable for surgery |
| title_full | Spinal metastasis with neurologic deficits: Outcome of late surgery in patients primarily deemed not suitable for surgery |
| title_fullStr | Spinal metastasis with neurologic deficits: Outcome of late surgery in patients primarily deemed not suitable for surgery |
| title_full_unstemmed | Spinal metastasis with neurologic deficits: Outcome of late surgery in patients primarily deemed not suitable for surgery |
| title_short | Spinal metastasis with neurologic deficits: Outcome of late surgery in patients primarily deemed not suitable for surgery |
| title_sort | spinal metastasis with neurologic deficits outcome of late surgery in patients primarily deemed not suitable for surgery |
| url | http://dx.doi.org/10.1080/17453674.2017.1412193 |
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