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A comparison of two different surgical procedures in the treatment of isolated spinal metastasis patients with metastatic spinal cord compression: a case–control study

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Abstract

Objective

The aim of the study was to compare total en bloc spondylectomy (TES) and separation surgery with postoperative stereotactic radiosurgery (SSRS) for isolated metastatic patients with spinal cord compression by assessing recurrence-free survival (RFS), overall survival (OS), postoperative complications, and quality of life scores (QoL).

Methods

From October 2013 to December 2020, 52 isolated spinal metastasis patients with cord compression were selected and separated into two groups based on the surgical method used (TES group, n = 26; and SSRS group, n = 26). Indexes for evaluation included postoperative Frankel grade, postoperative ECOG-PS, RFS, OS, postoperative complications, operation time, intraoperative blood loss, and QoL.

Results

The average follow-up duration was 31.44 months. There was no significant difference (P > 0.05) in postoperative complications and OS between the two groups. However, a significant difference in operation time, intraoperative blood loss, postoperative ECOG-PS, RFS, and mental health domain (6 months after surgery) was found between the two groups (P < 0.05). According to The Spine Oncology Study Group Outcomes Questionnaire assessment, the total pain and physical function domains scores were also elevated after surgery in both groups. However, no significant difference was observed between groups A and B (p = 0.450 and 0.446, respectively).

Conclusions

TES and SSRS were efficient methods for treating solitary spinal metastasis patients with metastatic spinal cord compression. Better local tumor control and mental health were found in the TES group, and most patients felt as if they were free of spinal tumors. Compared with TES, the SSRS caused less operation-related trauma. However, there was no significant difference in OS between the two groups.

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Funding

This work was supported by the National Natural Science Foundation of China (81972506).

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Author notes

  1. Shuang Cao, Xin Gao, Yue Zhang, and Yifan Wang have contributed equally to this work, and all the four authors can be regarded as first authors.

Authors and Affiliations

  1. Department of Orthopedics, Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China

    Shuang Cao, Yifan Wang, Ying Liu & Yejin Zhou

  2. Department of Orthopedics, Orthopaedic Oncology Center, Changzheng Hospital, Second Military Medical University, No. 415 Fengyang Road, Shanghai, Huangpu District, China

    Shuang Cao, Xin Gao, Yue Zhang, Jing Wang, Shuming Hou, Jiahao Zhang & Tielong Liu

  3. Department of Orthopedics, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China

    Tao Wang

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  1. Shuang Cao
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  2. Xin Gao
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  4. Yifan Wang
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  8. Shuming Hou
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Correspondence to Jiahao Zhang, Yejin Zhou or Tielong Liu.

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Cao, S., Gao, X., Zhang, Y. et al. A comparison of two different surgical procedures in the treatment of isolated spinal metastasis patients with metastatic spinal cord compression: a case–control study. Eur Spine J 31, 1583–1589 (2022). https://doi.org/10.1007/s00586-021-07032-7

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  • DOI: https://doi.org/10.1007/s00586-021-07032-7

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