title: Quality of life in surgical treatment of metastatic spine disease.
abstract: METHODS
  Overall quality of life after surgical management of metastatic disease of the spine was prospectively assessed using a validated global health status quality-of-life instrument-the Edmonton Symptom Assessment Scale.
  
  
  OBJECTIVE
  To prospectively evaluate the efficacy of surgery in patients with metastatic spinal disease with respect to quality of life.
  
  
  BACKGROUND
  Management of spinal metastases is palliative and is aimed at improving quality of life at an acceptable risk. Although previous studies have evaluated physical outcomes, improvements in pain, and neurologic function after surgery, a multidimensional assessment of quality of life is more relevant in the palliative patient.
  
  
  METHODS
  Twenty-five consecutive patients undergoing surgery for spinal metastases were prospectively evaluated. Pre- and postoperative assessments were performed using the Edmonton Symptom Assessment Scale. The surgical procedure consisted of decompression and instrumented stabilization.
  
  
  RESULTS
  After surgery, the largest improvement was noted in the domain of pain (P < 0.00001). There were also significant improvements noted in the domains of tiredness (P = 0.004), nausea (P = 0.01), anxiety (P = 0.006), drowsiness (P = 0.044), appetite (P = 0.02), and well-being (P = 0.004).
  
  
  CONCLUSIONS
  The current study demonstrates that in the appropriate patient, surgical management brings about a positive effect on the overall quality of life in patients with spinal metastases. The greatest benefit occurred in the reduction of a patient's level of pain.
authors.affiliation: Division of Orthopaedics, University of Toronto, Ontario, Canada.
authors.forename: Eugene K
authors.initials: EK
authors.lastname: Wai
authors.forename: Joel A
authors.initials: JA
authors.lastname: Finkelstein
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Tangente
authors.forename: Lori
authors.initials: L
authors.lastname: Holden
authors.forename: Edward
authors.initials: E
authors.lastname: Chow
authors.forename: Michael
authors.initials: M
authors.lastname: Ford
authors.forename: Albert
authors.initials: A
authors.lastname: Yee
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013125:Spinal Neoplasms / Q000556:secondary / Q000601:surgery*; D016896:Treatment Outcome