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Risk Factors and Prognosis of Surgery for Spinal Metastasis
HuiminTan ZhengmingYang ZhaomingYe DishengYang Weixu U
OBJECTIVE To evaluate the risk factors and prognosis of surgery for spinal metastasis. METHODS A retrospective analysis was performed for 63 patients with spinal metastasis who underwent surgical treatment between June 1992 and June 2002. Forty-one patients underwent anterior en-bloc or partial resection, decompression and reconstruction with internal fixation of the spine. Laminectomy and decompression with internal fixation were done in 8 patients. One-stage anterior-posterior en-bloc resection and decompression followed by reconstrL~ctive stabilization were conducted in 14 patients.
Department of Orthopedics, Institute of Orthopedic Research, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
RESULTS After follow-up for more than 6 months, postoperative radiological evaluation revealed that spinal stabilization was evident in all patients. Fiftyseven (91.9%) patients benefited with quality of life significantly improved through pain alleviation, and 41 (66.1%) patients improved in their neurological status, No serious complications were observed in surgery. The
Correspondence to: Huimin Tao Tel: 86-571-8778-3542
mean survival time after surgery was 6 months in patients with lung and liver carcinoma, 15 months with breast, prostate, and stomach carcinoma as well as the other miscellaneous malignancies, and 28 months with thyroid and kidr~ey carcinoma. Differences were significant among the 3 groups (P
80
Months
Sixty-two patients were accessed for neurolo~c function by a Frankel score 2 weeks after surgery, including Frankel A in 5 patients, B in 6, C in 9, D in 10
F~,3, Survivalgraph of 3 tumor categodes in 63 patients.
and E in 32. Postoperative neurologic improvement increased by a grading of 61.
1.2
During the follow-up, 48 patients died and 15
i, :?
patients survived. Mean postoperative survival time was _
13.6 months; 1 patient died on the third day, 1 died in
_
Anterior approach
the third month, 6 in the 4~6th month, 11 in the 7~9th
Posterior app~o~ch
month, 4 in the 10~.12th month, 21 in the first~second year, 3 in the third year, and 1 in the 6th year. Of the 63 patients, mean postoperative survival time
Anterior-Posterior approach
~"
'--7
was 6 months ~br patients with primary carcinoma of O. r!
the lung and liver. 15 months lbr patients with breast,
;;
2!)
gastrointestinal tract, prostate, and other carcinomas, and 28 months for patients with thyroid and renal cell carcinoma. There was a significant difference between any 2 of the 3 groups (P
