Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Local Recurrence and Development of Spinal Cord Syndrome during Follow-Up after Surgical Treatment of Metastatic Spine Disease

Peter Knoell
,
Moritz Lenschow
ORCID logo ,
Maximilian Lenz
,
Volker Neuschmelting
,
Niklas Von Spreckelsen
ORCID logo ,
Sergej Telentschak
,
Sebastian Olbrueck
ORCID logo ,
Maximilian Weber
,
Johannes Rosenbrock
,
Peer Eysel
,
Sebastian Gottfried Walter
*
Version 1 : Received: 31 August 2023 / Approved: 1 September 2023 / Online: 4 September 2023 (04:34:03 CEST)

A peer-reviewed article of this Preprint also exists.

Knöll, P.; Lenschow, M.; Lenz, M.; Neuschmelting, V.; von Spreckelsen, N.; Telentschak, S.; Olbrück, S.; Weber, M.; Rosenbrock, J.; Eysel, P.; Walter, S.G. Local Recurrence and Development of Spinal Cord Syndrome during Follow-Up after Surgical Treatment of Metastatic Spine Disease. Cancers 2023, 15, 4749. Knöll, P.; Lenschow, M.; Lenz, M.; Neuschmelting, V.; von Spreckelsen, N.; Telentschak, S.; Olbrück, S.; Weber, M.; Rosenbrock, J.; Eysel, P.; Walter, S.G. Local Recurrence and Development of Spinal Cord Syndrome during Follow-Up after Surgical Treatment of Metastatic Spine Disease. Cancers 2023, 15, 4749.

Abstract

Background: Surgical decompression (SD) with and without posterior stabilization followed by radiotherapy is an established treatment for patients with metastatic spinal disease with epidural spinal cord compression (ESCC). This study aims to identify risk factors for occurrence of neurologic comprise resulting from local recurrence. Methods: All patients who received surgical treatment for metastatic spinal disease at our center between 2011 and 2022 were included in this study. Cases were evaluated for tumor entity, surgical technique for decompression (decompression, hemilaminectomy, laminectomy, corpectomy) neurological deficits, grade of ESCC, time interval to radiotherapy and perioperative complications. Results: A total of 747 patients were included in the final analysis, with a follow-up of 296.8 days (95% CI (263.5, 330.1)). During the follow-up period 7.5% of patients developed spinal cord/cauda syndrome (SCS). Multivariate analysis revealed prolonged time (> 35 d) to radiation therapy as solitary risk factor (p < 0.001) for occurrence of SCS during follow-up. Conclusion: Surgical treatment of spinal metastatic disease improves patients’ quality of life and Frankel grade but radiation therapy needs to be scheduled within a time frame of few weeks in order to reduce the risk of tumor-induced neurologic comprise.

Keywords

ESCC; MSCC; spinal metastasis; decompression surgery; radiotherapy; spinal cord syndrome

Subject

Medicine and Pharmacology, Other

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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