PURPOSE: There are few prospective studies on surgical outcomes and survival in patients with metastatic disease to the spine. The magnitude and duration of effect of surgery on pain relief and quality of life remains uncertain. Therefore, the aim of this clinical study was to prospectively evaluate clinical, functional, quality of life and survival outcomes after palliative surgery for vertebral metastases. METHODS: 118 consecutive patients who underwent spinal surgery for symptomatic vertebral metastases were prospectively followed up for 12 months or until death. Clinical data and data from the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire were obtained pre- and post-operatively and at regular follow-up intervals. RESULTS: Surgery was effective in achieving rapid improvement in axial and radicular pain, neurological deficit, sphincteric dysfunction and ambulatory status, with a complication rate of 26% and a 12 month mortality rate of 48%. Almost 50% of patients had complete resolution of back pain, radiculopathy and neurological deficit. Of the patients who were non-ambulant and incontinent, over 50% regained ambulatory ability and recovered urinary continence. The overall incidence of wound infection or breakdown was 6.8% and the local recurrence rate was 8.5%. There was a highly significant improvement in physical, role, cognitive and emotional functioning and global health status post-operatively. Greatest improvement in pain, function and overall quality of life occurred in the early post-operative period and was maintained until death or during the 12 month prospective follow-up period. CONCLUSION: The potential for immediate and prolonged improvement in pain, function and quality of life in patients with symptomatic vertebral metastases should be considered during the decision-making process when selecting and counselling patients for surgery.
PURPOSE: There are few prospective studies on surgical outcomes and survival in patients with metastatic disease to the spine. The magnitude and duration of effect of surgery on pain relief and quality of life remains uncertain. Therefore, the aim of this clinical study was to prospectively evaluate clinical, functional, quality of life and survival outcomes after palliative surgery for vertebral metastases. METHODS: 118 consecutive patients who underwent spinal surgery for symptomatic vertebral metastases were prospectively followed up for 12 months or until death. Clinical data and data from the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire were obtained pre- and post-operatively and at regular follow-up intervals. RESULTS: Surgery was effective in achieving rapid improvement in axial and radicular pain, neurological deficit, sphincteric dysfunction and ambulatory status, with a complication rate of 26% and a 12 month mortality rate of 48%. Almost 50% of patients had complete resolution of back pain, radiculopathy and neurological deficit. Of the patients who were non-ambulant and incontinent, over 50% regained ambulatory ability and recovered urinary continence. The overall incidence of wound infection or breakdown was 6.8% and the local recurrence rate was 8.5%. There was a highly significant improvement in physical, role, cognitive and emotional functioning and global health status post-operatively. Greatest improvement in pain, function and overall quality of life occurred in the early post-operative period and was maintained until death or during the 12 month prospective follow-up period. CONCLUSION: The potential for immediate and prolonged improvement in pain, function and quality of life in patients with symptomatic vertebral metastases should be considered during the decision-making process when selecting and counselling patients for surgery.
Authors: Alexis Falicov; Charles G Fisher; Joe Sparkes; Michael C Boyd; Peter C Wing; Marcel F Dvorak Journal: Spine (Phila Pa 1976) Date: 2006-11-15 Impact factor: 3.468
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Authors: Rachit Kumar; Anick Nater; Ahmed Hashmi; Sten Myrehaug; Young Lee; Lijun Ma; Kristin Redmond; Simon S Lo; Eric L Chang; Albert Yee; Charles G Fisher; Michael G Fehlings; Arjun Sahgal Journal: Neurooncol Pract Date: 2015-07-27
Authors: L Bollen; G C W de Ruiter; W Pondaag; M P Arts; M Fiocco; T J T Hazen; W C Peul; P D S Dijkstra Journal: Eur Spine J Date: 2013-03-02 Impact factor: 3.134
Authors: F M Brooks; Ameet Ghatahora; M C Brooks; Hazel Warren; Laura Price; Pranter Brahmabhatt; Saik De Vauvert; Cerys John; Elizabeth Farnworth; Erwina Sulaiman; Sashin Ahuja Journal: Eur J Orthop Surg Traumatol Date: 2014-05-08