Local Recurrence and Development of Spinal Cord Syndrome during Follow-Up after Surgical Treatment of Metastatic Spine Disease
Author:
Knöll Peter1, Lenschow Moritz2ORCID, Lenz Maximilian1, Neuschmelting Volker2, von Spreckelsen Niklas2ORCID, Telentschak Sergej2, Olbrück Sebastian13ORCID, Weber Maximilian1, Rosenbrock Johannes4, Eysel Peer1, Walter Sebastian G.1ORCID
Affiliation:
1. Department of Orthopedics, Trauma Surgery and Plastic Surgery, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany 2. Department of General Neurosurgery, Center for Neurosurgery, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany 3. Faculty of Medicine, University of Cologne, 50937 Cologne, Germany 4. Department of Radiation Oncology, CyberKnife and Radiation Therapy, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
Abstract
Background: Surgical decompression (SD), with or without posterior stabilization followed by radiotherapy, is an established treatment for patients with metastatic spinal disease with epidural spinal cord compression (ESCC). This study aims to identify risk factors for occurrence of neurological compromise resulting from local recurrence. Methods: All patients who received surgical treatment for metastatic spinal disease at our center between 2011 and 2022 were included in this study. Cases were evaluated for tumor entity, surgical technique for decompression (decompression, hemilaminectomy, laminectomy, corpectomy) neurological deficits, grade of ESCC, time interval to radiotherapy, and perioperative complications. Results: A total of 747 patients were included in the final analysis, with a follow-up of 296.8 days (95% CI (263.5, 330.1)). During the follow-up period, 7.5% of the patients developed spinal cord/cauda syndrome (SCS). Multivariate analysis revealed prolonged time (>35 d) to radiation therapy as a solitary risk factor (p < 0.001) for occurrence of SCS during follow-up. Conclusion: Surgical treatment of spinal metastatic disease improves patients’ quality of life and Frankel grade, but radiation therapy needs to be scheduled within a time frame of a few weeks in order to reduce the risk of tumor-induced neurological compromise.
Subject
Cancer Research,Oncology
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