ObjectivesTo evaluate survival after surgery and indications for surgery due to spinal metastatic disease.DesignA retrospective longitudinal multiregistry nationwide cohort study.Setting19 public hospitals in Sweden with spine surgery service, where 6 university hospitals account for over 90% of the cases.Participants1820 patients 18 years or older undergoing surgery due to spinal metastatic disease 2006–2018 and registered in Swespine, the Swedish national spine surgery registry.InterventionsDecompressive and/or stabilising spine surgery due to spinal metastatic disease.Primary outcomeSurvival (median and mean) after surgery.Secondary outcomesIndications for surgery, types of surgery and causes of death.ResultsThe median estimated survival after surgery was 6.2 months (95% CI: 5.6 to 6.8) and the mean estimated survival time was 12.2 months (95% CI: 11.4 to 13.1). Neurologic deficit was the most common indication for surgery and posterior stabilisation was performed in 70.5% of the cases. A neoplasm was stated as the main cause of death for 97% of the patients.ConclusionBoth median and mean survival times were well above the generally accepted thresholds for surgical treatment for spinal metastases, suggesting that patient selection for surgical treatment on a national level is adequate. Further research on quality of life after surgery and prognostication is needed.
Preoperative embolisation, transpedicular decompression and posterior stabilisation for metastatic disease of the thoracic spine causing paraplegia