Surgical management and prognostic factors of spinal metastatic tumors

Abstract

This study aims to evaluate different prognostic factors after surgical management of metastatic spinal tumors regarding clinical condition, preoperative investigations, histopathological results, and surgical data. Seventy patients diagnosed as metastatic spinal tumors with neurological deficits and/or unstable spine operated for spinal decompression with or without instrumental fixation according to Spinal Instability Neoplastic Score (SINS) at our institute during the period from May 2014 to October 2018 with follow-up at least 9 months. Lymphoma metastases were the commonest spinal metastases of 23% with significant p value = 0.001, males and ages above 50 years old were significantly affected. High vascularity and bone invasion were significant operative findings. Significant good prognostic factors for both survival and Klekampe score improvement were paretic patients, > 15 preoperative Klekampe score, early surgery, ≤ 3 vertebral affection, extradural tumor location, gross total resection, and metastatic tumors from multiple myeloma, thyroid gland, lymphoma, and prostatic gland. Early surgeries aiming neural decompression and keeping spinal stability according to Spinal Instability Neoplastic Score for patients with spinal metastases are the main hope for better survival and neurological improvement.