Postoperative outcomes of subaxial cervical spine metastasis: Comparison among the anterior, posterior, and combined approaches
Issued Date
2022-06-01
Resource Type
ISSN
22121374
Scopus ID
2-s2.0-85126886850
Journal Title
Journal of Bone Oncology
Volume
34
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Bone Oncology Vol.34 (2022)
Suggested Citation
Luksanapruksa P., Santipas B., Rajinda P., Chueaboonchai T., Chituaarikul K., Bovonratwet P., Wilartratsami S. Postoperative outcomes of subaxial cervical spine metastasis: Comparison among the anterior, posterior, and combined approaches. Journal of Bone Oncology Vol.34 (2022). doi:10.1016/j.jbo.2022.100424 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85844
Title
Postoperative outcomes of subaxial cervical spine metastasis: Comparison among the anterior, posterior, and combined approaches
Author's Affiliation
Other Contributor(s)
Abstract
Background: The incidence of subaxial spinal metastases increases due to longer life expectancy resulting from successful modern cancer treatments. The three most utilized approaches for surgical treatment include the anterior, posterior, and combined approaches. However, despite increasing surgical volume, data on the postoperative complication profiles of different operative approaches for this patient population is scarce. Methods: The institutional databases of two large referral centers in Thailand were retrospectively reviewed. Patients with subaxial cervical spine metastasis who underwent cervical surgery during 2005 to 2015 were identified and enrolled. Clinical presentations, baseline characteristics, operative approach, perioperative complications, and postoperative outcomes, including pain, neurological recovery, and survival, were compared among the three surgical approaches. Results: The 70 patients (44 with anterior approach, 14 with posterior approach, 12 with combined approach) were enrolled. There were no statistically significant differences in preoperative characteristics, including Charlson Comorbidity Index (CCI), Tomita score, and Revised Tokuhashi score, among the three groups. There were no significant differences among groups for medical complications, surgical complications, neurological recovery, verbal pain score improvement, survival time, or ambulatory status improvement. However, the combined approach did show a significantly higher rate of overall perioperative complications (p = 0.01), intraoperative blood loss (p < 0.001), and operative time (p < 0.001) compared to the other two approaches. Conclusions: Patients in the combined approach group had the highest rates of perioperative complications. However, although the differences were not statistically significant, patients in the combined group tended to have better clinical outcomes after follow-up and the longest survival time.