Quality of life in surgical treatment of metastatic spine disease.
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.
Wai
Eugene K
EK
Division of Orthopaedics, University of Toronto, Ontario, Canada.
Finkelstein
Joel A
JA
Tangente
Ronald P
RP
Holden
Lori
L
Chow
Edward
E
Ford
Michael
M
Yee
Albert
A
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