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World Neurosurg ; 153: e28-e35, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34139354

RESUMO

OBJECTIVES: To investigate the effect of surgical stabilization for patients with metastatic spinal disease on objective mobility metrics. METHODS: A retrospective chart review identified patients who had mechanical back pain from metastatic spinal disease and underwent spinal stabilization during 2017. Mobility metrics, the Activity Measure for Post-Acute Care (AM-PAC) inpatient mobility short form (IMSF) and the Johns Hopkins Highest Level of Mobility (JH-HLM), were reviewed. RESULTS: A total of 26 patients were included in the analysis with median hospital stay of 8 days. Preoperative JH-HLM scores were available for 17 patients with a mean score of 5.4, increasing to mean score of 6.6 at last follow-up (P = 0.036). Preoperative AM-PAC IMSF scores were available for 14 patients with a mean score of 19.4, decreasing slightly to a mean score of 18.7 at last follow-up (P = 0.367). Last follow-up with mobility metrics occurred a median of 6.5 days postoperatively (range: 3-66 days). Multivariable analysis showed that American Spinal Injury Association and Karnofsky Performance Status scores were significantly associated with both JH-HLM and AM-PAC mobility scores at last follow-up. A higher JH-HLM or AM-PAC score was significantly associated with direct home discharge and a higher AM-PAC score was associated with shorter hospital stay. CONCLUSIONS: Surgical stabilization for patients with mechanical back pain secondary to metastatic spinal disease might lead to an objective improvement in JH-HLM score. JH-HLM and AM-PAC scores may be correlated with length of hospital stay and discharge disposition. Future studies are encouraged to further characterize the role of these mobility metrics in the management plan of these patients.


Assuntos
Dor nas Costas/cirurgia , Carcinoma/cirurgia , Laminectomia , Mieloma Múltiplo/cirurgia , Sarcoma/cirurgia , Fusão Vertebral , Neoplasias da Coluna Vertebral/cirurgia , Atividades Cotidianas , Idoso , Dor nas Costas/etiologia , Dor nas Costas/fisiopatologia , Neoplasias da Mama/patologia , Carcinoma/complicações , Carcinoma/fisiopatologia , Carcinoma/secundário , Carcinoma de Células Renais/complicações , Carcinoma de Células Renais/secundário , Carcinoma de Células Renais/cirurgia , Estudos de Coortes , Descompressão Cirúrgica , Feminino , Humanos , Avaliação de Estado de Karnofsky , Neoplasias Renais/patologia , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/complicações , Mieloma Múltiplo/fisiopatologia , Mieloma Múltiplo/secundário , Procedimentos Neurocirúrgicos , Neoplasias da Próstata/patologia , Estudos Retrospectivos , Sarcoma/complicações , Sarcoma/fisiopatologia , Sarcoma/secundário , Neoplasias da Coluna Vertebral/complicações , Neoplasias da Coluna Vertebral/fisiopatologia , Neoplasias da Coluna Vertebral/secundário
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