Risk Factors and Prognosis of Surgery for Spinal Metastasis

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 reconstructive stabilization were conducted in 14 patients.

RESULTS After follow-up for more than 6 months, postoperative radiological evaluation revealed that spinal stabilization was evident in all patients. Fifty-seven (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 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 kidney carcinoma. Differences were significant among the 3 groups (P< 0.01).

CONCLUSION Surgical treatment for spinal metastasis is able to relieve neurological symptoms and improve the quality of life. The survival time is related to the site of the primary tumor; shorter survival in lung and liver carcinoma, longer in breast, prostate, stomach carcinoma and longest in thyroid and kidney carcinoma.