Postoperative Complications and Spinal Metastases

Abstract

The spine is the most common site for skeletal metastasis. As improved treatment for primary cancer affords longer life expectancy, the incidence of spinal metastasis is increasing. Patients generally present with neck or back pain with or without neurological symptoms such as radicular pain, numbness, weakness, or myelopathy. Surgical treatment is palliative and is often used in conjunction with radiation and/or chemotherapy. The goals of surgery include mechanical stabilization, decompression of the neural elements, and optimization of the radiation target. The number of metastatic tumor patients undergoing surgery is growing. In spite of increased rates of surgical treatment, improved hardware and refined technique, the rate of surgery-related complications remains high. The most common complications are dural injury, wound infection and dehiscence, and hardware failure. The extent and severity of these complications can be mitigated by preoperative risk assessment with appropriate goal identification, intraoperative technique, and early recognition of postoperative deterioration.