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Metastatic spinal cord compression surgery may alleviate pain and improve autonomy
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Surgery for metastatic spinal cord compression decreased pain scores and improved patients’ autonomy and was associated with limited morbidity, according to study findings.
Researchers retrospectively analyzed the surgery outcomes, prognostic factors for survival, and relevance and accuracy of Tomita and Tokuhashi scores for patients with malignancies associated with metastatic spinal cord compression (MSCC).
A total of 148 patients underwent surgical treatment of MSCC at the researchers’ institution between 2004 and 2010. Among these patients, 73% had laminectomy with spinal fixation.
After surgery, results showed pain scores decreased in 75% of the patients, and 92% of the patients were ambulatory. Additionally, Frankel scores decreased in 31% of patients who underwent surgery. Complications were reported in 16% of patients, and median overall survival of 8.9 months after surgery.
The only spinal disease deficit score relevant to prognostic survival rate was the Tokuhashi score, but it had a predictive accuracy of survival of only 51%, according to the researchers. However, multivariate analysis demonstrated extrabone metastases, a Karnofsky performance status less than 70 and poor American Society of Anesthesiologist score — measurements of systemic disease extent and patients’ general condition — were all significantly associated with overall survival.
The researchers concluded the increase and occurrence of pain, as well as neurologic deficits, should be major factors in diagnosing metastatic spinal cord compression and performing surgery. – by Robert Linnehan.
Disclosure: The researchers report no relevant financial disclosures.
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