A survival prognostic factor analysis of decompression and internal ifxation of epidural spinal cord compression following spinal metastases
JIANG Wei-gang
LIU Yao-sheng
TANG Chuan-hao
YANG Shao-xin
ZHOU Shi-guo
LIU Shu-bin
Abstract：Objective To explore the survival prognostic factors of posterior decompression and internal ifxation for spinal metastases epidural spinal cord compression ( MESCC ).Methods From January 2006 to December 2014, 72 MESCC patients with thoracic vertebra metastases received posterior decompression and internal ifxation in the PLA 307th hospital. Data were collected, including gender, age, preoperative eastern cooperative oncology group ( ECOG ), Tokuhashi score ( primary tumor, preoperative KPS score, visceral metastasis, extraspinal bone metastases, number of spinal metastases and Frankel grade ), the time interval of the diagnosis of the primary tumor and spinal metastasis, the time of dyskinesia occurrence, distribution, continuity, pathological fracture of the affected vertebral body, postoperative adjuvant radiotherapy, chemotherapy and postoperative ambulatory state. etc. Using single-factor Kaplan-Meier analysis survival conditions of the exposure group to draw a survival curve. Using multi-factor Cox proportional hazards model to screen the independent prognostic factors of the posterior decompression and the internal ifxation in the thoracic MESCC.Results At the end of the follow-up of 72 cases, 62 cases died and 10 cases were alive. The median survival period was 7.45 months ( range: 0.3 - 91.9 months ). Five cases ( 7% ) died within 1 month after the surgery, 47 cases ( 65% ) died within 1 year after the surgery, and 55 cases ( 76% ) died within 2 years afterthe surgery. Single factor analysis showed that ambulation and postoperative adjuvant radiotherapy and chemotherapy prolonged survival period signiifcantly (P < 0.05 ) when age < 65, preoperative ECOG < 2 points, Tokuhashi score > 8 points, interval of diagnosis of the primary tumor and spinal metastasis < 24 months. Multi-factor Cox proportional hazards model showed Tokuhashi score, age, and ability of postoperative ambulation were independent survival prognostic factors of the decompression and internal fixation for MESCC.Conclusions Our study confirms the validity and reproducibility of the Tokuhashi score for outcome prediction in patients with MESCC. Nevertheless, age, postoperative ambulatory ability are also signiifcantly associated with the survival after the posterior decompression and internal ifxation of thoracic MESCC in our population.
Keywords：Bone neoplasmsThoracic vertebraeSpinal cord compressionDecompressionsurgicalPrognosis
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 284-289 )