The Outcome of Surgical Management of Solitary Spinal Metastasis

摘要

Spinal metastasis is common among cancer patients and it has great influence on their quality of life. It causes intractable pain, in addition to motor dysfunction. Surgery is an old widely acceptable treatment for solitary spinal lesions. It may serve as a palliative treatment as it helps to relieve pain, preserve or restore the neurological function. This study is to evaluate the effect of different surgical modalities on the improvement of the clinical status of patients with solitary spinal metastasis. We made a prospective study on 18 patients admitted to our neurosurgery department. Preoperatively, neurological status and pain were evaluated by the JOA scale, Frankel grade and VAS. MRI spine with contrast was done, and cord compression was assessed by ESCC scale. All patients were evaluated by Tokuhashi scoring system. Anterior approach was used in two patients, and Posterior approach was used in 16 patients with several surgical modalities. All the patients received post-operative radiotherapy and underwent follow up for 6 months. There is a significant statistical difference between pre and post-operative VAS and Frankel grade with (p-value=0.003) and (p-value=0.013) respectively. There is a significant correlation between pre-operative neurological status and the outcome. A strong factor influencing post-operative improvement of the patients was pre-operative neurological condition in this study.