Clinical Features of Metastatic Spine Tumor and Needs for Surgical Treatment

Lee, Jae Chul; Suh, Sung Wook; Kim, Woo Jin; Lim, Chang Kyun; Chang, Bong Soon; Lee, Choon Ki

Abstract

STUDY DESIGN: A retrospective study.
OBJECTIVES
To analyze the clinical features of spinal metastasis, and to evaluate what is the most appropriate treatment. SUMMARY OF LITERATURE REVIEW: Severe pain and neurological compromise induced by metastatic spine tumors deteriorates the quality of life. Surgical treatment may improve the quality of life effectively.
MATERIALS AND METHODS
Between January 1995 and May 1999, we studied 61 patients diagnosed for spinal metastasis, and followed for more than 1 year or to their death. They were divided into three groups, such as surgery group, radiotherapy group, and other conservative therapy group. The results were evaluated with Turgut classification for functional status, WHO analgesics cascade for pain grading, and Frankel classification for neurological symptoms.
RESULTS
Forty nine patients were followed to death. The average of survival time was 15 months, and it depends on the histology of primary tumor. In the review of treatment methods, non-operative treatment was preferred by medical oncologist in majority of cases. Eleven patients were treated surgically, and their pains and neurological symptoms were improved in varing degrees. But in case of posterior decompression alone, pain was not relieved. Surgical decompression with stabilization was effective for pain and neurological symptoms. In 50 patients, radiotherapy or other conservative therapy was applied, but results were not satisfactory.
CONCLUSION
In view of the quality of life, surgical treatment should be considered in more cases of patients suffering from severe pain and neurological symptoms caused by metastatic spine tumor.