title: Palliative surgery for cervical spine metastasis.
abstract: BACKGROUND
  The present study aimed to assess the immediate/early clinical outcomes and surgical results of 11 consecutive patients who underwent palliative cervical spine surgery for symptomatic spinal metastases.
  
  
  METHODS
  This single-surgeon retrospective case series analysed 12 surgical procedures that were performed for symptomatic cervical spinal metastasis in 11 consecutive patients. All surgeries were carried out at Singapore General Hospital, Singapore, from 2007 to 2013. Preoperative medical oncological assessment/staging was performed on each patient--all patients presented with either axial neck pain or neurological deficits, and had no bladder or bowel symptoms. The primary outcomes analysed were postoperative neurological power and improvement in neck pain.
  
  
  RESULTS
  Anterior (n = 5), posterior (n = 4) and combined (n = 2) surgical approaches were used for decompression and stabilisation. Comparing between pre- and postoperative pain scores (scored according to the visual analog scale), and pre- and postoperative limb power scores (scored according to the Medical Research Council scale for muscle strength), we found that all patients showed improvement in their symptoms. Postoperatively, patients had either improvement or preservation of neurological power, and all patients had a decrease in axial neck pain after surgery. Although there was one case of minor pedicle screw instrumentation malplacement, this did not result in any neurological symptoms. Median survival for the patients was 108 (range 7‒1,095) days.
  
  
  CONCLUSIONS
  Palliative surgery for cervical spine metastasis is safe with good neurological results, low complication rates, and improvement in neck pain. A multidisciplinary approach involving surgeons, medical oncologists and radiotherapists is needed to optimise patient care and outcome.
authors: Jai
authors: J
authors: Rao
authors: 6 Napier Road, #08-08, Gleneagles Medical Centre, Singapore 258499. rajspineclinic@gmail.com.
authors: Rajendra
authors: R
authors: Tiruchelvarayan
authors: Lester
authors: L
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000556:secondary* / Q000601:surgery*; D055815:Young Adult
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