Recent advances and new discoveries in the pipeline of the treatment of primary spinal tumors and spinal metastases: A scoping review

2021 ◽  
Author(s):  
Julio C Furlan ◽  
Jefferson R Wilson ◽  
Eric M Massicotte ◽  
Arjun Sahgal ◽  
Fehlings G Michael
Keyword(s):  
Spinal Cord ◽  
Scoping Review ◽  
Clinical Studies ◽  
Spinal Metastasis ◽  
Spinal Cord Tumor ◽  
Treatment Strategies ◽  
Spinal Metastases ◽  
Spinal Tumors ◽  
Spinal Neoplasms ◽  
Primary Tumors

Abstract The field of spinal oncology has substantially evolved over the past decades. This review synthesizes and appraises what was learned and what will potentially be discovered from the recently completed and ongoing clinical studies related to the treatment of primary and secondary spinal neoplasms. This scoping review included all clinical studies on the treatment of spinal neoplasms registered in the ClinicalTrials.gov website from February/2000 to December/2020. The terms “spinal cord tumor”, “spinal metastasis”, and “metastatic spinal cord compression” were used. Of the 174 registered clinical studies on primary spinal tumors and spinal metastasis, most of the clinical studies registered in this American registry were interventional studies led by single institutions in North America (n=101), Europe (n=43), Asia (n=24) or other continents (n=6). The registered clinical studies mainly focused on treatment strategies for spinal neoplasms (90.2%) that included investigating stereotactic radiosurgery (n=33), radiotherapy (n=21), chemotherapy (n=20), and surgical technique (n=11). Of the 69 completed studies, the results from 44 studies were published in the literature. In conclusion, this review highlights the key features of the 174 clinical studies on spinal neoplasms that were registered from 2000 to 2020. Clinical trials were heavily skewed towards the metastatic population as opposed to the primary tumours which likely reflects the rarity of the latter condition and associated challenges in undertaking prospective clinical studies in this population. This review serves to emphasize the need for a focused approach to enhancing translational research in spinal neoplasms with a particular emphasis on primary tumors.

scholarly journals Transthoracic vertebrectomy for metastatic spinal tumors

1998 ◽  
Vol 5 (2) ◽  
pp. E2 ◽  
Author(s):  
Ziya L. Gokaslan ◽  
Julie E. York ◽  
Garrett L. Walsh ◽  
Ian E. McCutcheon ◽  
Frederick F. Lang ◽  
...  
Keyword(s):  
Spinal Metastasis ◽  
Posterior Instrumentation ◽  
Spinal Metastases ◽  
Neurological Dysfunction ◽  
Spinal Tumors ◽  
Cancer Center ◽  
Primary Tumors ◽  
Entire Study ◽  
Lower Extremity Weakness ◽  
Presenting Symptoms

Anterior approaches to the spine for the treatment of spinal tumors have gained acceptance; however, in most published reports, patients with primary, metastatic, or chest wall tumors involving cervical, thoracic, or lumbar regions of the spine are combined. The purpose of this study was to provide a clear perspective of results that can be expected in patients who undergo anterior vertebral body resection, reconstruction, and stabilization for spinal metastases that are limited to the thoracic region. Outcome is presented for 72 patients with metastatic spinal tumors who were treated by transthoracic vertebrectomy at The University of Texas M. D. Anderson Cancer Center. The predominant primary tumors included renal cancer in 19 patients, breast cancer in 10, melanoma or sarcoma in 10, and lung cancer in nine patients. The most common presenting symptoms were back pain, which occurred in 90% of patients, and lower-extremity weakness, which occurred in 64% of patients. All patients underwent transthoracic vertebrectomy, decompression, reconstruction with methylmethacrylate, and anterior fixation with locking plate and screw constructs. Supplemental posterior instrumentation was required in seven patients with disease involving the cervicothoracic or thoracolumbar junction, which was causing severe kyphosis. After surgery, pain improved in 60 of 65 patients. This improvement was found to be statistically significant (p < 0.001) based on visual analog scales and narcotic analgesic medication use. Thirty-five of the 46 patients who presented with neurological dysfunction improved significantly (p < 0.001) following the procedure. Thirty-three patients had weakness but could ambulate preoperatively. Seventeen of these 33 regained normal strength, 15 patients continued to have weakness, and one patient was neurologically worse postoperatively. Of the 13 preoperatively nonambulatory patients, 10 could walk after surgery and three were still unable to walk but showed improved motor function. Twenty-one patients had complications ranging from minor atelectasis to pulmonary embolism. The 30-day mortality rate was 3%. The 1-year survival rate for the entire study population was 62%. These results suggest that transthoracic vertebrectomy and spinal stabilization can improve the quality of life considerably in cancer patients with spinal metastasis by restoring or preserving ambulation and by controlling intractable spinal pain with acceptable rates of morbidity and mortality.

scholarly journals MRI-guided stereotactic ablative radiation therapy of spinal bone metastases: a preliminary experience

2020 ◽  
Vol 93 (1105) ◽  
pp. 20190655
Author(s):  
Ricardo Llorente ◽  
Benjamin O Spieler ◽  
James Victoria ◽  
Cristiane Takita ◽  
Raphael Yechieli ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Soft Tissues ◽  
Spinal Cord Tumor ◽  
Cauda Equina ◽  
Spinal Metastases ◽  
Patient Positioning ◽  
Stereotactic Ablative Radiotherapy ◽  
Spinal Bone Metastases ◽  
Mri Guided ◽  
Dose Constraints

Objective: MRI provides clear visualization of spinal cord, tumor, and bone for patient positioning and verification during MRI-guided radiotherapy (MRI-RT). Therefore, we wished to evaluate spine stereotactic ablative radiotherapy (SABR) feasibility with MRI-RT. Given dosimetric limitations of first generation Co-60 MRI-RT, we then evaluated improvements by newer linear accelerator (linac) MRI-RT. Methods: Nine spinal metastases were treated with Co-60 MRI-RT. Seven received a single 16 Gy fraction, and two received three fractions totaling 24 or 30 Gy. After replanning with linac MRI-RT software, comparisons of organ at risk and dose spillage objectives between Co-60 and linac plans were performed. Results: Spinal cord and cauda equina dose constraints were met in all Co-60 cases. Treatments were delivered successfully with real-time imaging during treatment and no treatment-related toxicities. While limits for dose spillage into surrounding soft tissues were not achieved due to the limitations of the Co-60 system, this could be corrected with linac MRI-RT delivery. Conclusions: MRI-RT SABR of spinal metastases is feasible with Co-60 MRI-RT. Dose delivery is improved by linac MRI-RT. Advances in knowledge: This is the first report of MRI-RT for SABR of spinal metastases. The enhanced visualization of anatomy by MRI may facilitate RT dose escalation for spine SABR.

scholarly journals LOCALIZATION AND HISTOLOGICAL STRUCTURE OF SPINAL CORD TUMORS IN PATIENTS IN SUMY REGION

2019 ◽  
Vol 7 (4) ◽  
pp. 372-376
Author(s):  
O. O. Potapov ◽  
O. P. Kmyta ◽  
O. O. Tsyndrenko ◽  
N. O. Dmytrenko ◽  
E. V. Kolomiets ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Nervous System ◽  
Diagnosis And Treatment ◽  
Surrounding Tissue ◽  
Spinal Tumors ◽  
Histological Structure ◽  
Spinal Cord Tumors ◽  
Primary Tumors ◽  
Intradural Tumor ◽  
The Brain

Spinal cord tumors include tumors developing from its parenchyma, vessels, roots and membranes. The main theory of the formation of spinal cord tumors is the polyetiological dysontogenetic theory. According to this theory, hereditary factors, dysembriogenesis, trauma, carcinogenic effects, viral infection, intoxication, radiation, etc. play an important role in the development of tumors. Although scientists keep finding out more about genetic and environmental factors influencing the development of many types of tumors, spinal tumors are still a relatively unknown subject. Spinal tumors partially contain pathological genes, but in many cases, researchers don't know what causes these genetic changes. Tumors of the central nervous system (CNS) make up 12% of all tumors, tumors of the spinal cord – 3% of nervous system disorders, in the structure of malignant lesions of the CNS – 1,4-5%, occur mainly at the age of 20-60 years. In children, as well as in elderly and senile persons, these tumors are rare. Most often, they develop not from the brain matter, but from the surrounding tissue, and when they increase in size, they compress the spinal cord. Spinal tumors are usually divided into primary and secondary. The group of primary tumors include tumors, originating from the brain matter (intramedullar tumors), and those that grow from the membranes of the brain, roots, vessels (extramedullar tumors). Extramedullar tumors are much more common (in 80% of all spinal tumors) than intramedullar tumors. Extramedullar tumors can be both subdural and epidural. The majority of extramedullar tumors are subdural. Occasionally there are tumors, some of which are located inside the dural sac, and some – outside the dura mater, they are subdural-epidural tumors, as well as epidural-extrovertebral tumors. Among extramedullar tumors the most commonly diagnosed are meningiomas and neurinomas, among intramedullar the most common are ependymomas, less common are astrocytomas and oligodendroglioma. Glioblastomas of the spinal cord is extremely rare; the most common metastases from the posterior fossa are medulloblastomas. Intracerebral tumors of the spinal cord are characterized by greater biological benignity, than similar brain tumors. Extracerebral spinal cord tumors have no such differences in their biological properties. In general, spinal cord tumors are more common in elderly patients. Neurinomas and meningiomas predominate in adults, and ependymomas and dysgenetic tumors (teratoma, epidermoid cysts) – in children. Peculiarities of etiopathogenetic aspects, clinical course, influence on socio-economic factors encourage further improvement of diagnosis and more detailed study of this type of tumors. Materials and methods. The analysis of medical records of patients with spinal cord tumors, who were hospitalized in neurological departments of the Sumy Regional and 4th City Clinical Hospitals in 2015-2018 was carried out. 69 clinical cases were processed in order to investigate the prevalence of spinal cord tumors in the Sumy region, the characteristics of the disease in this group of patients, the leading symptoms, methods of diagnosis and treatment. The analysis of statistical data, obtained after processing of the research materials, was carried out using the licensed version of the IBM SPSS Statistics 17 software. Our study significantly established that, according to the histological structure, in 46 patients (28 women and 18 men) meningiomas were predominant and that in 31 patients they were located at the level of Th6-Th12. Mainly in 42 patients (33 women and 9 men, p<0.05) spinal cord neoplasms were localized at the level of Th6-Th12, with extramedular-intradural tumor location – 57 patients (38 women and 19 men). According to our study, pain syndrome significantly prevailed in 42 patients (35 with extramedular-intradural tumor localization). The study of the histological structure of tumors depending on their localization is an integral part of both diagnosis and treatment, and an important component of predicting the quality of life of the patient.

scholarly journals En bloc spondylectomy for spinal metastases: a review of techniques

2003 ◽  
Vol 15 (5) ◽  
pp. 1-6 ◽  
Author(s):  
Kevin C. Yao ◽  
Stefano Boriani ◽  
Ziya L. Gokaslan ◽  
Narayan Sundaresan
Keyword(s):  
Treatment Strategies ◽  
Spinal Metastases ◽  
Staging System ◽  
Surgical Staging ◽  
Spinal Tumors ◽  
Surgical Approaches ◽  
En Bloc ◽  
En Bloc Spondylectomy ◽  
Effective Treatment Modality ◽  
Bloc Spondylectomy

Object Spinal metastases are prevalent in the population of patients with cancer. Effective cancer therapy must incorporate treatment strategies for these lesions. Increasingly, surgery is being recognized as an effective treatment modality both for the patient's quality of life and potential oncological cure. En bloc spondylectomy is the surgical procedure of choice to obtain these goals. The purpose of this study was to examine critically the rationale, indications, and outcomes of en bloc spondylectomy for spinal metastases. Methods Outcomes in the authors' series of patients who underwent en bloc spondylectomy for spinal metastases are critically analyzed. The rationale and indications for this procedure are discussed. The Weinstein, Boriani, and Biagini surgical staging system for spinal tumors is described. A review of the literature is performed to examine further the rationale underlying this aggressive surgical approach to metastatic spinal disease. Conclusions En bloc spondylectomy is the treatment of choice for solitary and oligometastatic spinal metastases with biologically favorable histological findings. In appropriately selected patients, neurological outcome, pain control, and oncological control are significantly better after en bloc spondylectomy compared with radiation therapy. Oncological outcomes also exceed those of intralesional techniques. The Weinstein, Boriani, and Biagini surgical staging system provides a standard with which to plan surgical approaches and to compare surgical outcomes.

scholarly journals Hospital Frailty Risk Score and Healthcare Resource Utilization After Surgery for Primary Spinal Intradural/Cord Tumors

2022 ◽  
pp. 219256822110699
Author(s):  
Aladine A. Elsamadicy ◽  
Andrew B. Koo ◽  
Benjamin C. Reeves ◽  
Zach Pennington ◽  
Margot Sarkozy ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Risk Score ◽  
Perioperative Complications ◽  
Hospital Costs ◽  
Spinal Tumors ◽  
Primary Tumors ◽  
Discharge Disposition ◽  
Nationwide Inpatient Sample Database ◽  
Icd 10 ◽  
The Impact

Objective The Hospital Frailty Risk Score (HFRS) is a metric that measures frailty among patients in large national datasets using ICD-10 codes. While other metrics have been utilized to demonstrate the association between frailty and poor outcomes in spine oncology, none have examined the HFRS. The aim of this study was to investigate the impact of frailty using the HFRS on complications, length of stay, cost of admission, and discharge disposition in patients undergoing surgery for primary tumors of the spinal cord and meninges. Methods A retrospective cohort study was performed using the Nationwide Inpatient Sample database from 2016 to 2018. Adult patients undergoing surgery for primary tumors of the spinal cord and meninges were identified using ICD-10-CM codes. Patients were categorized into 2 cohorts based on HFRS score: Non-Frail (HFRS<5) and Frail (HFRS≥5). Patient characteristics, treatment, perioperative complications, LOS, discharge disposition, and cost of admission were assessed. Results Of the 5955 patients identified, 1260 (21.2%) were Frail. On average, the Frail cohort was nearly 8 years older ( P < .001) and experienced more postoperative complications ( P = .001). The Frail cohort experienced longer LOS ( P < .001), a higher rate of non-routine discharge ( P = .001), and a greater mean cost of admission ( P < .001). Frailty was found to be an independent predictor of extended LOS ( P < .001) and non-routine discharge ( P < .001). Conclusion Our study is the first to use the HFRS to assess the impact of frailty on patients with primary spinal tumors. We found that frailty was associated with prolonged LOS, non-routine discharge, and increased hospital costs.

Spinal dural resection for oncological purposes: a systematic analysis of risks and outcomes in patients with malignant spinal tumors

2020 ◽  
Vol 32 (1) ◽  
pp. 69-78
Author(s):  
Sean M. Barber ◽  
Sanjay Konakondla ◽  
Jonathan Nakhla ◽  
Jared S. Fridley ◽  
Jimmy Xia ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Epithelioid Sarcoma ◽  
Tumor Resection ◽  
Spinal Metastases ◽  
Neurological Deficits ◽  
Spinal Tumors ◽  
Spinal Neoplasms ◽  
Oncological Outcomes ◽  
Small Series

OBJECTIVEOncological outcomes for many malignant primary spinal tumors and isolated spinal metastases have been shown to correlate with extent of resection. For tumors with dural involvement, some authors have described spinal dural resection at the time of tumor resection in the interest of improving oncological outcomes. The complication profile associated with resection of the spinal dura for oncological purposes, however, and the relative influence of resecting tumor-involved dura on progression-free survival are not well defined. The authors performed a systematic review of the literature and identified cases in which the spinal dura was resected for oncological purposes in the interest of better understanding the associated risks and outcomes of this technique.METHODSElectronic databases (PubMed/MEDLINE, Scopus) were systematically searched to identify studies that reported clinical and/or oncological outcomes of patients with malignant spinal neoplasms undergoing resection of tumor-involved dura at the time of surgical intervention.RESULTSTen articles describing 15 patients were included in the analysis. The most common tumor histologies were chordoma (3/15, 20%), giant cell tumor (3/15, 20%), epithelioid sarcoma (2/15, 13.3%), osteosarcoma (2/15, 13.3%), and metastasis (2/15, 13.3%). Procedure-related complications were reported in 40% of patients. A trend was seen toward an increased complication rate in redo (66.7%) versus index (16.7%) operations, but this trend did not reach statistical significance (p = 0.24). New, unexpected postoperative neurological deficits were seen in 3 patients (of 14 reporting, 21.4%). A single patient experienced a profound, unexpected neurological deterioration (paraparesis/paraplegia) after surgery, which reportedly improved considerably at latest follow-up. Tumor recurrence was seen in 3 cases (of 12 reporting, 25%) at a mean of 28.34 ± 21.1 months postoperatively. The overall mean radiographic follow-up period was 49.6 ± 36.5 months.CONCLUSIONSResection of the spinal dura for oncological purposes is rarely performed, although a limited number of reports and small series have demonstrated that it is feasible. Spinal dural resection is primarily performed in patients with isolated, primary spinal neoplasms with an intent to cure. The risk associated with spinal dura resection is nontrivial and the complication profile is significant. The influence of dural resection on oncological outcomes is not well defined, and further study is needed before definitive conclusions may be drawn regarding the oncological benefit of dural resection for any particular patient or pathology.

Transthoracic vertebrectomy for metastatic spinal tumors

1998 ◽  
Vol 89 (4) ◽  
pp. 599-609 ◽  
Author(s):  
Ziya L. Gokaslan ◽  
Julie E. York ◽  
Garrett L. Walsh ◽  
Ian E. McCutcheon ◽  
Frederick F. Lang ◽  
...  
Keyword(s):  
Spinal Metastases ◽  
Neurological Dysfunction ◽  
Spinal Tumors ◽  
Cancer Center ◽  
Primary Tumors ◽  
Entire Study ◽  
Lower Extremity Weakness ◽  
Content Type ◽  
Presenting Symptoms ◽  
Fine Print

Object. Anterior approaches to the spine for the treatment of spinal tumors have gained acceptance; however, in most published reports, patients with primary, metastatic, or chest wall tumors involving cervical, thoracic, or lumbar regions of the spine are combined. The purpose of this study was to provide a clear perspective of results that can be expected in patients who undergo anterior vertebral body resection, reconstruction, and stabilization for spinal metastases that are limited to the thoracic region. Methods. Outcome is presented for 72 patients with metastatic spinal tumors who were treated by transthoracic vertebrectomy at The University of Texas M. D. Anderson Cancer Center. The predominant primary tumors included renal cancer in 19 patients, breast cancer in 10, melanoma or sarcoma in 10, and lung cancer in nine patients. The most common presenting symptoms were back pain, which occurred in 90% of patients, and lower-extremity weakness, which occurred in 64% of patients. All patients underwent transthoracic vertebrectomy, decompression, reconstruction with methylmethacrylate, and anterior fixation with locking plate and screw constructs. Supplemental posterior instrumentation was required in seven patients with disease involving the cervicothoracic or thoracolumbar junction, which was causing severe kyphosis. After surgery, pain improved in 60 of 65 patients. This improvement was found to be statistically significant (p < 0.001) based on visual analog scales and narcotic analgesic medication use. Thirty-five of the 46 patients who presented with neurological dysfunction improved significantly (p < 0.001) following the procedure. Thirty-three patients had weakness but could ambulate preoperatively. Seventeen of these 33 regained normal strength, 15 patients continued to have weakness, and one patient was neurologically worse postoperatively. Of the 13 preoperatively nonambulatory patients, 10 could walk after surgery and three were still unable to walk but showed improved motor function. Twenty-one patients had complications ranging from minor atelectasis to pulmonary embolism. The 30-day mortality rate was 3%. The 1-year survival rate for the entire study population was 62%. Conclusions. These results suggest that transthoracic vertebrectomy and spinal stabilization can improve the quality of life considerably in cancer patients with spinal metastasis by restoring or preserving ambulation and by controlling intractable spinal pain with acceptable rates of morbidity and mortality.

Reliability analysis of the epidural spinal cord compression scale

2010 ◽  
Vol 13 (3) ◽  
pp. 324-328 ◽  
Author(s):  
Mark H. Bilsky ◽  
Ilya Laufer ◽  
Daryl R. Fourney ◽  
Michael Groff ◽  
Meic H. Schmidt ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Imaging Techniques ◽  
Spinal Metastases ◽  
Cord Compression ◽  
Spinal Tumors ◽  
Mr Images ◽  
Intrarater Reliability ◽  
Thoracic Spinal ◽  
Sagittal Image

Objective The evolution of imaging techniques, along with highly effective radiation options has changed the way metastatic epidural tumors are treated. While high-grade epidural spinal cord compression (ESCC) frequently serves as an indication for surgical decompression, no consensus exists in the literature about the precise definition of this term. The advancement of the treatment paradigms in patients with metastatic tumors for the spine requires a clear grading scheme of ESCC. The degree of ESCC often serves as a major determinant in the decision to operate or irradiate. The purpose of this study was to determine the reliability and validity of a 6-point, MR imaging–based grading system for ESCC. Methods To determine the reliability of the grading scale, a survey was distributed to 7 spine surgeons who participate in the Spine Oncology Study Group. The MR images of 25 cervical or thoracic spinal tumors were distributed consisting of 1 sagittal image and 3 axial images at the identical level including T1-weighted, T2-weighted, and Gd-enhanced T1-weighted images. The survey was administered 3 times at 2-week intervals. The inter- and intrarater reliability was assessed. Results The inter- and intrarater reliability ranged from good to excellent when surgeons were asked to rate the degree of spinal cord compression using T2-weighted axial images. The T2-weighted images were superior indicators of ESCC compared with T1-weighted images with and without Gd. Conclusions The ESCC scale provides a valid and reliable instrument that may be used to describe the degree of ESCC based on T2-weighted MR images. This scale accounts for recent advances in the treatment of spinal metastases and may be used to provide an ESCC classification scheme for multicenter clinical trial and outcome studies.

scholarly journals Immunoglobulin G4-Related Disease Masquerading an Epidural Spinal Cord Tumor

2021 ◽  
Author(s):  
Ebtesam Abdulla ◽  
Harleen Luther ◽  
Tejal Shah ◽  
Nisha Chandran
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Spinal Cord Tumor ◽  
Cord Compression ◽  
Spinal Tumors ◽  
Immunoglobulin G4 ◽  
Related Disease ◽  
First Case ◽  
Unclear Etiology

Background Immunoglobulin G4–related disease (IgG4-RD) is a recently identified multisystemic fibroinflammatory condition of unclear etiology. IgG4-RD of the epidural tissue causing spinal cord compression is extremely rare. Case description Here, we present a 27-year-old male with epidural mass, causing spinal cord compression at the level of D5-D6. The mass proved pathologically to be epidural inflammatory pseudotumor (IPT) related to IgG4. Spinal decompression was done. The patient was started on steroid treatment and reported a complete resolution of his symptoms over a 3 years’ follow-up period. Conclusion To the authors’ knowledge, this is the first case of IgG4-related epidural IPT and spinal cord compression in Bahrain and the Middle East. IgG4-RD should always be considered as a part of the differential diagnosis of spinal tumors.

scholarly journals Outcomes of Surgical Decompression for Spinal Metastases From Gynecological Cancers: A Retrospective Cohort Study

2021 ◽  
Vol 7 (1) ◽  
pp. 37-48
Author(s):  
Luiz Alves Vieira Netto ◽  
◽  
Luís Felipe Araújo Peres ◽  
Nayara Matos Pereira ◽  
Alice Jardim Zaccariotti1 ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Overall Survival ◽  
Spinal Injury ◽  
Spinal Metastasis ◽  
Gynecological Cancer ◽  
Spinal Metastases ◽  
Decompressive Surgery ◽  
Neurological Deficits ◽  
Spinal Instability ◽  
Spinal Stability

Background and Aim: Gynecological cancer is one of the most common types of cancer worldwide. Nonetheless, spinal metastasis from gynecological cancer is scarcely reported in the literature. In cases of spinal cord compression, the standard treatment is a decompressive surgery followed by radiotherapy treatment for selected patients. This study aimed to report the overall survival and surgical results in patients presenting with gynecological spinal metastases who underwent spinal cord/nerve root decompression and stabilization. Methods and Materials/Patients: A total of 18 patients were included in this study. The surgical procedures were performed from 2012 to 2019. The evaluation of neurological status, spinal stability, and pain were performed using the American Spinal Injury Association Impairment Scale (ASIA), Spinal Instability Neoplastic Score (SINS), and Visual Analogue Scale (VAS), respectively. Results: The lumbar spine was the most affected location (n=30; 50.0%). Regarding the preoperative neurological deficits, 16 cases (n=16; 88.9%) presented ASIA graded A–D before the surgery, being reduced to five (n=5; 27.8%) after the procedures. The pain level means (pre-and postoperative) were 9.39±0.79 and 2.28±1.44. The overall median survival was 6.1 months (95% Confidence Interval [CI] of 1.10–11.13 months). The mean survival of ambulatory and non-ambulatory patients before the surgery was 7.36 months and 3.2 months, respectively (P=0.007 – Log-rank Mantel–Cox). Conclusion: Decompressive surgery and stabilization promote mechanical pain relief, spinal stability, an improvement of neurological function, and indirectly improving quality of life, despite a dismal overall survival of patients who present with metastatic spinal compression disease.

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