Hohenberger, Christoph and Schmidt, Corinna and Hoehne, Julius and Brawanski, Alexander and Zeman, Florian and Schebesch, Karl-Michael (2018) Effect of surgical decompression of spinal metastases in acute treatment - Predictors of neurological outcome. JOURNAL OF CLINICAL NEUROSCIENCE, 52. pp. 74-79. ISSN 0967-5868, 1532-2653
Full text not available from this repository. (Request a copy)Abstract
Objective: Space-occupying spinal metastases (SM), commonly diagnosed because of acute neurological deterioration, consequently lead to immediate decompression with tumor removal or debulking. In this study, we analyzed a series of patients with surgically treated spinal metastases and explicitly sought to determine individual predictors of functional outcome. Patients and methods: 94 patients (26 women, 68 men; mean age 64.0 years) with spinal metastases, who had been surgically treated at our department, were included retrospectively. We reviewed the pre- and postoperative charts, surgical reports, radiographic data for demographics, duration of symptoms, histopathology, stage of systemic disease, co-morbidities, radiographic extension, surgical strategy, neurological performance (Frankel Grade Classification), and the Karnofsky Performance Index (KPI). Results: Emergency surgery within <24 h after discharge had been conducted in 33% of patients. Prostate carcinoma (29.5%) and breast carcinoma (11.6%) were the most common histopathologies. Median KPI was 60% at admission that had significantly improved at discharge (KPI 70%; p = 0.01). The rate of complications without revision was 4.3%, the revision rate 4.2%. From admission to discharge, pain had been significantly reduced (p = 0.019) and motor deficits significantly improved (p = 0.003). KPI had been significantly improved during in-hospital treatment (median 60 vs 70, p = 0.010). In the multivariable analysis, predictors of poor outcome (KPI < 70) were male sex, multiple metastases, and pre-existing bowel and bladder dysfunction. Median follow up was 2 months. Discussion: In our series, surgery for spinal metastases (laminectomy, tumor removal, and mass reduction) significantly reduced pain as well as sensory and motor deficits. We identified male sex, multiple metastases, and pre-existing bowel and bladder dysfunction as predictors of negative outcome. (C) 2018 Elsevier Ltd. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CORD COMPRESSION; PROGNOSTIC-FACTORS; CLINICAL ARTICLE; SURGERY; SURVIVAL; MANAGEMENT; DISEASE; CANCER; Spinal metastases; Functional outcome; Neurosurgery; Spinal surgery; Laminectomy; Tumor debulking |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Neurochirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 17 Feb 2020 13:04 |
| Last Modified: | 17 Feb 2020 13:04 |
| URI: | https://pred.uni-regensburg.de/id/eprint/14517 |
Actions (login required)
 |
View Item |
