IS SPINAL METASTASIS PALLIATIVE SURGERY WARRANTED?

Background: There is no consensus on the preferred treatment for spinal metastasis patients. Aims: We evaluated 63 patients undergoing surgery for spinal metastasis at our Institute, in an attempt to revise the indications for these surgical procedures. Methods: The study population was divided into two groups: patients with cord compression and those with intractable pain only. Patients' Frankel score, ambulatory and incontinence status were examined before surgery, at discharge and at last follow up and their cumulative survival was analyzed . Results: Patients with cord compression showed no significant differences in the Frankel score at the different points in time. Cord compression patients' continence status deteriorated at the last visit. Median survival of the cord compression and non-cord compression groups was 201 and 402 days, respectively (p=0.317). Conclusions: Since the benefits of surgery are weighed against survival, overall survival is gloomy in both groups of patients, by definition, and the functional level of most patients has deteriorated at last follow up, surgeons should probably refrain from aggressive treatment of these patients. A revision of the indications for spinal metastasis surgery should be undertaken