抄録
Because of the extended survival of cancer patients resulting from improvements in medical treatment, those with metastatic spinal tumors are increasing. Accordingly, it is necessary to reconsider the classification of spinal metastases and the surgical strategies used for treating them. In this study, we evaluated the postoperative outcomes and prognoses of patients with spinal metastases, and on the basis of our findings suggested suitable treatment strategies.
Eighteen patients with metastatic spinal tumors underwent surgical treatment between January 2000 and May 2011. The mean age of the patients was 64 years (range 42 to 78 years). All were followed for more than 3 months. The mean Tokuhashi score was 11.1 (range 7 to 15) points. Irrespective of the Tokuhashi score, all the patients except for one survived more than 6 months after surgery. At 3 months after surgery, 7 patients had recovered from paralysis, and 9 had achieved reduction of their severe back pain. Five patients recovered and maintained their activities of daily living. In terms of the Japanese Orthopedics Association score, 35% of the patients achieved improvement. In this series, no exacerbation of paralysis and no skeletal-related events occurred.
Surgery for metastatic spinal tumors produces good result, even in patients with advanced cancer. Furthermore, molecular-targeted drugs are effective for a proportion of cancers, and the survival rate has increased even in patients with rapidly progressive tumors. Our findings suggest that the indications for surgical intervention in patients with metastatic spinal tumors need to be reconsidered.
