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Metastatic epidural spinal cord compression: does timing of surgery influence the chance of neurological recovery? An observational case-control study.
Pipola, Valerio; Terzi, Silvia; Tedesco, Giuseppe; Bandiera, Stefano; Bròdano, Giovanni Barbanti; Ghermandi, Riccardo; Evangelisti, Gisberto; Girolami, Marco; Gasbarrini, Alessandro.
Afiliación
  • Pipola V; Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy. valeriopipola@gmail.com.
  • Terzi S; Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.
  • Tedesco G; Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.
  • Bandiera S; Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.
  • Bròdano GB; Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.
  • Ghermandi R; Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.
  • Evangelisti G; Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.
  • Girolami M; Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.
  • Gasbarrini A; Department of Oncologic and Degenerative Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.
Support Care Cancer ; 26(9): 3181-3186, 2018 Sep.
Article en En | MEDLINE | ID: mdl-29600414
ABSTRACT

PURPOSE:

Metastatic epidural spinal cord compression (MESCC) is radiologically defined as an epidural metastatic lesion causing the displacement of the spinal cord from its normal position in the vertebral canal. The purpose of this paper is the evaluation of the influence of timing of surgery on the chance of neurological recovery.

METHODS:

This is a retrospective observational case-control study performed on patients with MESCC from solid tumors surgically treated at our institute from January 2010 to December 2016. Patients included were divided in two groups depending on surgery that was performed within or after 24 h the admission to the hospital. Neurological status was assessed with American Spine Injury Association (ASIA) Impairment Scale.

RESULTS:

No statistically significant difference was observed in the variation of ASIA if surgery is performed within or after 24 h from the admission to the hospital. A statistically significant difference was observed after surgery in each group in the improvement of neurological status. A statistically significant difference was reported in the early post-operative complications in patients surgically treated within 24 h.

CONCLUSION:

MESCC management is challenge for spine surgeons and may represent an oncologic emergency and if not promptly diagnosed can lead to a permanent neurological damage. According to this study, there is no difference in the chance of neurological recovery if surgery is performed within or after 24 h the admission to hospital, but there is a greater rate of early post-operative complications when surgery is performed within 24 h from the admission to the hospital.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Compresión de la Médula Espinal / Neoplasias de la Columna Vertebral / Descompresión Quirúrgica Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Support Care Cancer Asunto de la revista: NEOPLASIAS / SERVICOS DE SAUDE Año: 2018 Tipo del documento: Article País de afiliación: Italia

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Compresión de la Médula Espinal / Neoplasias de la Columna Vertebral / Descompresión Quirúrgica Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Support Care Cancer Asunto de la revista: NEOPLASIAS / SERVICOS DE SAUDE Año: 2018 Tipo del documento: Article País de afiliación: Italia