An Updated Review of the Surgical Techniques and Outcomes for Metastatic Spinal Cord Compression

Abstract

Metastatic spinal cord compression (MSCC) is a condition associated with high morbidity and mortality. It affects up to 5% of patients with cancer and continues to increase in prevalence with advances in cancer care. In certain cases, surgical management is required for management of pain, neurological decline, and mechanical instability. Various surgical approaches and techniques have been utilized with traditional open and minimally invasive surgery both shown to be effective in improving patients’ function and quality of life. Predictors of survival and functional outcomes following surgery for MSCC include primary tumor type, performance status, and preoperative neurological status. Several prognostic models have been created and validated to assist clinicians in appropriate patient selection. Complications following surgery for MSCC are varied, with wound infection and dehiscence being the most frequently reported. There remains considerable variation in reported outcomes and the decision to pursue surgery should be carefully considered in the context of the individual patient’s prognosis and goals of care.