MATERIAL AND METHODS: The medical records of 51 patients who were diagnosed with thoracolumbar spinal metastatic tumour and underwent palliative single-stage posterior approach spinal surgery between June 2015 and June 2022 were recruited retrospectively. Patient demographic data, pre-operative and post-operative pain scores, neurological assessment and survival duration were collected from the medical records. Radiological findings were studied using respective imaging and reports.
RESULTS: The mean age was 57.5 years, and the median survival was nine months after the surgical treatment. The post-operative pain improvements were statistically significant at two weeks (VAS improved from 5 to 2), and three months follow-up VAS was one (p<0.001 and p=0.009, respectively). At initial presentation, patients with a single-level spinal involvement had higher VAS compared to multiple spinal metastases (p=0.018). A total of 18 (35.3%) patients had improved one or more ASIA grades, of which eight (15.7%) of them had gain of ambulatory function (p<0.001). Twenty-seven (52.9%) patients were ambulatory post-operative. The slow growth type of primary carcinoma, post-operative ambulatory ability, and the absence of perioperative morbidity were factors associated with favourable survival duration (p=0.006, p<0.001 and p<0.001, respectively). Synchronous visceral metastases adversely affected the survival duration (p=0.008).
CONCLUSION: Single-stage posterior decompression and stabilisation improved the clinical outcomes of spinal pain and neurological deficit in metastatic spinal tumours. Type of primary tumour, visceral metastasis, perioperative morbidity, and post-operative ambulatory status significantly impact post-operative survival duration.