Epidemiology and national trends in prevalence and surgical management of metastatic spinal disease.

Autor: Horn SR; Department of Orthopaedic Surgery, New York University Langone Orthopedic Hospital, New York, NY 10003, United States., Dhillon ES; Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States., Poorman GW; Department of Orthopaedic Surgery, New York University Langone Orthopedic Hospital, New York, NY 10003, United States., Tishelman JC; Department of Orthopaedic Surgery, New York University Langone Orthopedic Hospital, New York, NY 10003, United States., Segreto FA; Department of Orthopaedic Surgery, New York University Langone Orthopedic Hospital, New York, NY 10003, United States., Bortz CA; Department of Orthopaedic Surgery, New York University Langone Orthopedic Hospital, New York, NY 10003, United States., Moon JY; Department of Orthopaedic Surgery, New York University Langone Orthopedic Hospital, New York, NY 10003, United States., Behery O; Department of Orthopaedic Surgery, New York University Langone Orthopedic Hospital, New York, NY 10003, United States., Shepard N; Department of Orthopaedic Surgery, New York University Langone Orthopedic Hospital, New York, NY 10003, United States., Diebo BG; SUNY Downstate Medical Center, Brooklyn, NY 11203, United States., Vira S; Department of Orthopaedic Surgery, New York University Langone Orthopedic Hospital, New York, NY 10003, United States., Passias PG; Department of Orthopaedic Surgery, New York University Langone Orthopedic Hospital, New York, NY 10003, United States. Electronic address: peter.passias@nyumc.org.
Jazyk: angličtina
Zdroj: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia [J Clin Neurosci] 2018 Jul; Vol. 53, pp. 183-187. Date of Electronic Publication: 2018 Apr 19.
DOI: 10.1016/j.jocn.2018.04.022
Abstrakt: Surgical treatment for spinal metastasis has benefited from improvements in surgical techniques. However, the trends in treatment and outcomes for spinal metastasis surgery have not been well-established in a pediatric population. Patients <20 years old with metastatic spinal tumors undergoing spinal surgery were identified in the KID database. Trends for spinal metastases treatment and patient outcomes were analyzed using weight-adjusted ANOVAs. 333 patients were identified in the KID database. The top five primary diagnoses were metastatic brain/spinal cord tumor (19.8%), metastatic nervous system tumor (15.9%), metastatic bone cancer (13.2%), spinal cord tumor (4.2%), and tumor of ventricles (3.0%). There was an increased incidence of spinal metastasis diagnoses from 2003 to 2012 (88.5-117.9 per 100,000; p < 0.001) and an increased trend in the incidence of surgical treatment for spinal metastasis from 2003 to 2012 (p = 0.014). The average age was 10.19 ± 6.33 years old and 38.4% were female. The average length of stay was 17.34 ± 24.36 days. Average CCI increased over time (2003: 7.87 ± 1.40, 2012: 8.44 ± 1.39; p = 0.006). The most common surgeries were excision of spinal cord/meninges lesions (69.1%) and decompression of spinal canal (38.1%). Length of hospital stay and in-hospital mortality did not change over time (17.34-18.04 days, p = 0.337; 1.6%-2.9%, p = 0.801). 10.5% of patients underwent a posterior fusion and 22.2% had at least one complication (nervous system, respiratory, dysphagia, infection). The overall complication rate remained stable over time (23.4%-21.8%, p = 0.952). Surgical treatment for spinal metastasis in the last decade has increased, though the complication rates, in-hospital mortality, and length of stay have remained stable.
(Copyright © 2018 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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