Surgical results of metastatic spinal cord compression secondary to non-small cell lung cancer.
METHODS
The results for 37 surgical interventions in 31 consecutive patients with non-small cell lung cancer (NSCLC) with symptomatic spinal cord compression were reviewed retrospectively.


OBJECTIVE
To evaluate postoperative outcomes and survival rates of NSCLC patients surgically treated for symptomatic spinal metastasis.


BACKGROUND
For patients with spinal cord compression secondary to lung cancer, the prognosis is usually poor. However, with the development of new chemotherapeutic drugs and targeted therapeutic agents, the survival rate may be better.


METHODS
From November 2000 to March 2005, 31 patients with symptomatic metastatic spinal cord compression secondary to NSCLC underwent palliative surgery using a posterolateral transpedicular approach (PTA) or combined posterior and anterior procedures. The indication for surgery was neurologic progression due to spinal cord compression.


RESULTS
The patients ranged in age from 20 to 81 years (mean, 61.4 years). Twenty-eight patients (90%) underwent PTA, and 3 patients had combined posterior and anterior procedures. Neurologic improvement by at least one Frankel grade was noted in 25 of 31 cases (80%). Overall, 74% of patients (23 of 31) were able to walk after surgery. There was no case of intraoperative mortality, but two deaths occurred in the postoperative period. Median survival time was 8.8 months.


CONCLUSIONS
Even though lung cancer is considered an aggressive tumor, it is justifiable to aggressively treat patients with symptomatic spinal cord compression. Surgery by PTA can lead to good results in these patients.
Chen
Yen-Jen
YJ
Department of Orthopedic Surgery, China Medical University Hospital, Taichung, Taiwan. yenjenc@yahoo.com
Chang
Gee-Chen
GC
Chen
Hsien-Te
HT
Yang
Tsung-Ying
TY
Kuo
Benjamin Ing-Tiau
BI
Hsu
Horng-Chaung
HC
Yang
Hui-Wen
HW
Lee
Tu-Sheng
TS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods / Q000706:statistics & numerical data; D015174:Epidural Neoplasms / Q000556:secondary / Q000601:surgery; D004824:Epidural Space / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods / Q000706:statistics & numerical data; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D013115:Spinal Canal / Q000473:pathology / Q000601:surgery; D013117:Spinal Cord Compression / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D013125:Spinal Neoplasms / Q000556:secondary* / Q000601:surgery*; D013131:Spine / Q000473:pathology / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome