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Journal of Bone and Joint Surgery - British Volume, Vol 85-B, Issue 7, 1045-1050.
doi: 10.1302/0301-620X.85B7.14201  
Copyright © 2003 by British Editorial Society of Bone and Joint Surgery
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A population-based study of surgery for spinal metastases

SURVIVAL RATES AND COMPLICATIONS

J. Finkelstein, MD, Consultant Orthopaedic Surgeon1; G. Zaveri, FRCS, Consultant Orthopaedic Surgeon1; E. Wai, MD, Consultant Orthopaedic Surgeon1; M. Vidmar, MSc2; H. Kreder, MD, Consultant Orthopaedic Surgeon1; and E. Chow, MD, MSc, Consultant Radiation Oncologist3

1 Department of Orthopaedic Surgery, Sunnybrook and Women’s College Health Sciences Centre, Room MG 301, 2075 Bayview Avenue, Toronto, Ontario, Canada M4N 3MS.
2 Institute for Work and Health, 481 University Avenue, Suite 800, Toronto, Ontario, Canada M5G 2E9.
3 Department of Radiation Oncology, Toronto Sunnybrook Regional Cancer Center, 2075 Bayview Avenue, Toronto, Ontario, Canada M4N 3M5.

Correspondence should be sent to Dr J. A. Finkelstein.

The management of spinal metastases is palliative and aimed at improving quality of life at an acceptable risk. This population study uses administrative databases and measures survivorship and complication rates after surgery for spinal metastases. The effects of various potential predictor variables were evaluated. We identified 987 patients with a median survival for all types of cancer of 227 days. The one and three-month mortality was 9% and 29%, respectively. Increasing age, male gender and primary lung cancer were significant risk factors for death within 30 days of surgery. A preoperative neurological deficit contributed a 19% increase in mortality and a 71% increase in the risk of postoperative wound infection. We found an overall major complication rate of 27%. This information will provide patients, families and clinicians with objective data which will help in the choice of treatment and the understanding of the surgical risk and outcome.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General