Posterior decompression and stabilization for metastatic spine diseases.
BACKGROUND
The purpose of this study was to investigate the clinical results of posterior decompression and stabilization for metastatic diseases of the thoracolumbar spine.


METHODS
From 1980 to 2001, 70 consecutive patients with spinal metastases underwent palliative surgery by posterior decompression of spinal cord and subsequent stabilization with instrumentation. There were 38 women and 32 men. Their ages ranged from 24 to 75 years (mean 58 years). We retrospectively reviewed medical records to analyze their survival, clinical presentations, image findings and surgical outcomes.


RESULTS
Sixty-one patients (87%) survived longer than 3 months. Forty-nine patients (70%) survived longer than 6 months, of whom 35 patients were still alive at an average of 24 months (range 13-40 months) after surgery. All maintained spinal stability postoperatively. Forty-seven of 60 patients (78.3%) with severe pain obtained significant symptomatic relief for 3 months or more, and 38 of 54 (70.1%) paralyzed patients gained neural improvement. Of the 60 patients bedridden before surgery due to pain or paresis, 36 patients (60%) experienced an increase in activity tolerance.


CONCLUSIONS
The results of this study shows that neurological recovery, pain relief and mobility can be enhanced by posterior decompression and stabilization in highly selective patients with spinal metastases.
Chen
Lih-Huei
LH
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taipei. lhchen2132@adm.cgmh.org.tw
Niu
Chi-Chien
CC
Fu
Tsai-Sheng
TS
Lai
Po-Liang
PL
Wong
Chak-Bor
CB
Chen
Wen-Jer
WJ
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology; D008113:Liver Neoplasms / Q000473:pathology; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011300:Preoperative Care; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology; D013001:Somatoform Disorders / Q000601:surgery; D013125:Spinal Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D015996:Survival Rate; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery; D013964:Thyroid Neoplasms / Q000473:pathology; D016896:Treatment Outcome