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https://doi.org/10.18502/jsp.v1i2.9902
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Sami Aleissa
Sami Aleissa
Department of Orthopedic Surgery, National Guard-Health Affairs, Riyadh, Saudi Arabia
-
Faisal Konbaz
Faisal Konbaz
Department of Orthopedic Surgery, National Guard-Health Affairs, Riyadh, Saudi Arabia
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Firas Alsebayel
Firas Alsebayel
Department of Orthopedic Surgery, National Guard-Health Affairs, Riyadh, Saudi Arabia
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Abdullah Eissa
Abdullah Eissa
Department of Orthopedic Surgery, National Guard-Health Affairs, Riyadh, Saudi Arabia
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Nawaf Alogayyel
Nawaf Alogayyel
Department of Orthopedic Surgery, National Guard-Health Affairs, Riyadh, Saudi Arabia
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Ali Alhandi
Ali Alhandi
Department of Orthopedic Surgery, National Guard-Health Affairs, Riyadh, Saudi Arabia
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Muath Almajed
Muath Almajed
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Anouar Bourghli
Anouar Bourghli
Department of Orthopedic Surgery, Kingdom Hospital, Riyadh, Saudi Arabia
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Fahad Alhelal
Fahad Alhelal
Department of Orthopedic Surgery, National Guard-Health Affairs, Riyadh, Saudi Arabia
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Majed Abaalkhail
Majed Abaalkhail
Department of Orthopedic Surgery, National Guard-Health Affairs, Riyadh, Saudi Arabia
Published Date
- Jul 19, 2022
The morbidity and mortality rates following surgery in metastatic spine disease patients
Abstract
Background: Metastasis is one of the most frequent causes of cancer-related deaths globally. Several studies have investigated the surgical outcome of a metastatic spine; however, the results are discordant. This research aims to study the mortality and morbidity rates of surgical intervention for metastatic spine disease and the predictors of postoperative complications in a tertiary care center.
Materials and Methods: A retrospective chart review was conducted. The population consisted of patients who underwent surgical intervention for metastatic spine disease in a tertiary-care hospital from 2016 to 2020. The primary outcomes were intraoperative and postoperative complications, 30- day mortality, 90-day mortality, and the 1-year survival rates.
Results: A total of 47 patients underwent a surgical intervention during the period. Breast cancer was the most frequent primary lesion for the metastasis, followed by multiple myeloma and lung cancer. Postoperative surgical complications occurred in 34% of the sample, and 41% reported marked neurological improvement following surgery. The 30-day and 90-day mortality rates were 2% and 12%, respectively. The overall one-year survival rate was 64%.
Conclusion: The current study indicated that despite the risk and complexity of the surgical intervention to the metastatic spine, the surgery resulted in an acceptable rate of morbidity and mortality.
Keywords:
Spine metastasis, Spine surgery, Outcome, Mortality and morbidity, Metastasis, Saudi Arabia
References
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[2] Harrington KD. Metastatic tumors of the spine: Diagnosis and treatment. JAAOS 1993; 1(2): 76–86.
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[15] Jacobs WB, Perrin RG. Evaluation and treatment of spinal metastases: An overview. Neurosurg Focus 2001; 11(6): e10.
[16] Deng Z, Xu B, Jin J, Zhao J, Xu H. Strategies for management of spinal metastases: A comprehensive review. Cancer Transl Med 2015; 1(3): 94–100.
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[19] Wise JJ, Fischgrund JS, Herkowitz HN, Montgomery D, Kurz LT. Complication, survival rates, and risk factors of surgery for metastatic disease of the spine. Spine 1999; 24(18): 1943–1951.
[20] Jansson KA, Bauer HC. Survival, complications and outcome in 282 patients operated for neurological deficit due to thoracic or lumbar spinal metastases. Eur Spine J 2006; 15(2): 196–202.
[21] Ibrahim A, Crockard A, Antonietti P, Boriani S, Bünger C, Gasbarrini A, et al. Does spinal surgery improve the quality of life for those with extradural (spinal) osseous metastases? An international multicenter prospective observational study of 223 patients. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2007. J Neurosurg Spine 2008; 8(3): 271–278.
[22] Schilling AT, Ehresman J, Huq S, Ahmed AK, Lubelski D, Cottrill E, et al. Risk factors for wound-related complications after surgery for primary and metastatic spine tumors: A systematic review and meta-analysis. World Neurosurg 2020; 141: 467–478.e3.
[23] Quan GM, Vital JM, Aurouer N, Obeid I, Palussière J, Diallo A, et al. Surgery improves pain, function and quality of life in patients with spinal metastases: A prospective study on 118 patients. Eur Spine J 2011; 20(11): 1970–1978.
[24] Paulino Pereira NR, Ogink PT, Groot OQ, Ferrone ML, Hornicek FJ, van Dijk CN, et al. Complications and reoperations after surgery for 647 patients with spine metastatic disease. Spine J 2019; 19(1): 144–156.
[25] Amelot A, Balabaud L, Choi D, Fox Z, Crockard HA, Albert T, et al. Surgery for metastatic spine tumors in the elderly. Advanced age is not a contraindication to surgery! Spine J 2017; 17(6): 759–767.
[26] Bakar D, Tanenbaum JE, Phan K, Alentado VJ, Steinmetz MP, Benzel EC, et al. Decompression surgery for spinal metastases: A systematic review. Neurosurg Focus 2016; 41(2): E2.
[27] Lee BH, Park JO, Kim HS, Park YC, Lee HM, Moon SH. The perioperative complication and surgical outcome in patients with spine metastases: Retrospective 200-case series in a single institute. Clin Neurol Neurosurg 2014; 122: 80–86.
[28] Luksanapruksa P, Buchowski JM, Zebala LP, Kepler CK, Singhatanadgige W, Bumpass DB. Perioperative complications of spinal metastases surgery. Clin Spine Surg 2017; 30(1): 4–13.
[29] Finkelstein JA, Zaveri G, Wai E, Vidmar M, Kreder H, Chow E. A population-based study of surgery for spinal metastases. Survival rates and complications. J Bone Joint Surg Br 2003; 85(7): 1045–1050.
[30] Hussain AK, Cheung ZB, Vig KS, Phan K, Lima MC, Kim JS, et al. Hypoalbuminemia as an independent risk factor for perioperative complications following surgical decompression of spinal metastases. Global Spine J 2019; 9(3): 321–330.
[2] Harrington KD. Metastatic tumors of the spine: Diagnosis and treatment. JAAOS 1993; 1(2): 76–86.
[3] Suva LJ, Washam C, Nicholas RW, Griffin RJ. Bone metastasis: Mechanisms and therapeutic opportunities. Nat Rev Endocrinol 2011; 7(4): 208–218.
[4] Delank KS, Wendtner C, Eich HT, Eysel P. The treatment of spinal metastases. Dtsch Arztebl Int 2011; 108(5): 71–79; quiz 80.
[5] Galgano M, Fridley J, Oyelese A, Telfian A, Kosztowski T, Choi D, et al. Surgical management of spinal metastases. Expert Rev Anticancer Ther 2018; 18(5): 463–472.
[6] Kaloostian PE, Zadnik PL, Etame AB, Vrionis FD, Gokaslan ZL, Sciubba DM. Surgical management of primary and metastatic spinal tumors. Cancer Control 2014; 21(2): 133–139.
[7] Liang T, Wan Y, Zou X, Peng X, Liu S. Is surgery for spine metastasis reasonable in patients older than 60 years? Clin Orthop Relat Res 2013; 471(2): 628–639.
[8] Tang Y, Qu J, Wu J, Liu H, Chu T, Xiao J, et al. Effect of surgery on quality of life of patients with spinal metastasis from non-small-cell lung cancer. J Bone Joint Surg Am 2016; 98(5): 396–402.
[9] Yoshihara H, Yoneoka D. Trends in the surgical treatment for spinal metastasis and the in-hospital patient outcomes in the United States from 2000 to 2009. Spine J 2014; 14(9): 1844–1849.
[10] Aziz NM. Cancer survivorship research: State of knowledge, challenges and opportunities. Acta Oncol 2007; 46(4): 417–432.
[11] Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien-Dindo classification of surgical complications: Five-year experience. Ann Surg 2009; 250(2): 187–196.
[12] Choi M, Craft B, Geraci SA. Surveillance and monitoring of adult cancer survivors. Am J Med 2011; 124(7): 598–601.
[13] Patil CG, Lad SP, Santarelli J, Boakye M. National inpatient complications and outcomes after surgery for spinal metastasis from 1993-2002. Cancer 2007; 110(3): 625–630.
[14] Rothrock RJ, Barzilai O, Reiner AS, Lis E, Schmitt AM, Higginson DS, et al. Survival trends after surgery for spinal metastatic tumors: 20-year cancer center experience. Neurosurgery 2021; 88(2): 402–412.
[15] Jacobs WB, Perrin RG. Evaluation and treatment of spinal metastases: An overview. Neurosurg Focus 2001; 11(6): e10.
[16] Deng Z, Xu B, Jin J, Zhao J, Xu H. Strategies for management of spinal metastases: A comprehensive review. Cancer Transl Med 2015; 1(3): 94–100.
[17] Li Z, Long H, Guo R, Xu J, Wang X, Cheng X, et al. Surgical treatment indications and outcomes in patients with spinal metastases in the cervicothoracic junction (CTJ). J Orthop Surg Res 2018; 13(1): 20.
[18] Abdelbaky A, Eltahawy H. Neurological outcome following surgical treatment of spinal metastases. Asian J Neurosurg 2018; 13(2): 247–249.
[19] Wise JJ, Fischgrund JS, Herkowitz HN, Montgomery D, Kurz LT. Complication, survival rates, and risk factors of surgery for metastatic disease of the spine. Spine 1999; 24(18): 1943–1951.
[20] Jansson KA, Bauer HC. Survival, complications and outcome in 282 patients operated for neurological deficit due to thoracic or lumbar spinal metastases. Eur Spine J 2006; 15(2): 196–202.
[21] Ibrahim A, Crockard A, Antonietti P, Boriani S, Bünger C, Gasbarrini A, et al. Does spinal surgery improve the quality of life for those with extradural (spinal) osseous metastases? An international multicenter prospective observational study of 223 patients. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2007. J Neurosurg Spine 2008; 8(3): 271–278.
[22] Schilling AT, Ehresman J, Huq S, Ahmed AK, Lubelski D, Cottrill E, et al. Risk factors for wound-related complications after surgery for primary and metastatic spine tumors: A systematic review and meta-analysis. World Neurosurg 2020; 141: 467–478.e3.
[23] Quan GM, Vital JM, Aurouer N, Obeid I, Palussière J, Diallo A, et al. Surgery improves pain, function and quality of life in patients with spinal metastases: A prospective study on 118 patients. Eur Spine J 2011; 20(11): 1970–1978.
[24] Paulino Pereira NR, Ogink PT, Groot OQ, Ferrone ML, Hornicek FJ, van Dijk CN, et al. Complications and reoperations after surgery for 647 patients with spine metastatic disease. Spine J 2019; 19(1): 144–156.
[25] Amelot A, Balabaud L, Choi D, Fox Z, Crockard HA, Albert T, et al. Surgery for metastatic spine tumors in the elderly. Advanced age is not a contraindication to surgery! Spine J 2017; 17(6): 759–767.
[26] Bakar D, Tanenbaum JE, Phan K, Alentado VJ, Steinmetz MP, Benzel EC, et al. Decompression surgery for spinal metastases: A systematic review. Neurosurg Focus 2016; 41(2): E2.
[27] Lee BH, Park JO, Kim HS, Park YC, Lee HM, Moon SH. The perioperative complication and surgical outcome in patients with spine metastases: Retrospective 200-case series in a single institute. Clin Neurol Neurosurg 2014; 122: 80–86.
[28] Luksanapruksa P, Buchowski JM, Zebala LP, Kepler CK, Singhatanadgige W, Bumpass DB. Perioperative complications of spinal metastases surgery. Clin Spine Surg 2017; 30(1): 4–13.
[29] Finkelstein JA, Zaveri G, Wai E, Vidmar M, Kreder H, Chow E. A population-based study of surgery for spinal metastases. Survival rates and complications. J Bone Joint Surg Br 2003; 85(7): 1045–1050.
[30] Hussain AK, Cheung ZB, Vig KS, Phan K, Lima MC, Kim JS, et al. Hypoalbuminemia as an independent risk factor for perioperative complications following surgical decompression of spinal metastases. Global Spine J 2019; 9(3): 321–330.