Total subaxial reconstruction

2010 ◽  
Vol 13 (4) ◽  
pp. 424-434 ◽  
Author(s):  
Vincent C. Traynelis
Keyword(s):  
Cervical Spine ◽  
Visual Analog Scale ◽  
Anterior Decompression ◽  
Analog Scale ◽  
Excellent Outcome ◽  
Arm Pain ◽  
Subaxial Cervical Spine ◽  
Pain Scores ◽  
The Mean

Object Certain cervical spinal conditions require decompression and reconstruction of the entire subaxial cervical spine. There are limited data concerning the clinical details and outcomes of patients treated in this manner. The object of this study was to describe the specific technique employed to perform a total subaxial reconstruction and review the postoperative outcomes following surgery. Methods The author performed a review of data prospectively collected in 27 consecutive patients undergoing complete anterior decompression and reconstruction of the anterior cervical spine and followed by posterior instrumented arthrodesis with or without decompression. Results There were 16 men and 11 women whose mean age was 59 years (range 35–86 years). The minimum follow-up was 12 months and the mean follow-up period for all patients was 26 months. One patient underwent C2–7 surgery, and in all others the procedure crossed the cervicothoracic junction. Following surgery patients remained intubated for an average of 3.3 days (range 1–22 days). The mean hospital length of stay was 11 days (range 3–45 days). One patient died 6 weeks following an uneventful surgery. Pneumonia developed in 5 patients, 1 patient experienced a minor pulmonary embolism, and 2 patients had posterior wound infections. No patient was neurologically worse following surgery. A single patient presented with a C-8 radiculopathy 6 weeks after surgery. At final follow-up no patient complained of dysphagia when specifically questioned about this potential problem. In all patients solid fusions developed at each treated levels. Preoperatively the mean sagittal Cobb angle was 15.4° (kyphosis) and the postoperative mean angle was −10.9° (lordosis) representing a total average correction of over 25° (p < 0.0001). The mean preoperative Neck Disability Index was 27.6; this score decreased to 15.5 (p = 0.0008) postoperatively. The mean pre- and postoperative visual analog scale neck pain scores were 6.0 and 2.1, respectively (p = 0.0004), and mean visual analog scale arm pain scores decreased by 3.7 following surgery (p = 0.001). Based on Odom criteria, the author found that 8 patients had an excellent outcome and 14 patients a good outcome. There were 4 patients in whom the outcome was judged to be fair and the single death was recorded as a poor outcome. The mean preoperative Nurick score was 2.68. Postoperatively the group improved to an average score of 1.5; the difference between the 2 was statistically significant (p = 0.002). Conclusions Segmental anterior decompression and reconstruction of the entire subaxial cervical spine, combined with an instrumented posterolateral fusion, can be performed with acceptable morbidity and is of significant benefit in selected patients.

scholarly journals Standalone Instrumented Posterior Approach Used as Universal Approach for Tuberculosis Spondylodiscitis

2019 ◽  
Vol 10 (02) ◽  
pp. 225-233
Author(s):  
Mantu Jain ◽  
Rabi Narayan Sahu ◽  
Sudarsan Behera ◽  
Rajesh Rana ◽  
Sujit Kumar Tripathy ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Vertebral Body ◽  
Posterior Approach ◽  
Spinal Tuberculosis ◽  
X Rays ◽  
Analog Scale ◽  
Bony Fusion ◽  
Universal Approach ◽  
The Mean

ABSTRACT Background: Surgical management of spinal tuberculosis (TB) has been classically the anterior, then combined, and of late increasingly by the posterior approach. The posterior approach has been successful in early disease. There has been a paradigm shift and inquisitive to explore this approach in the more advanced and even long-segment disease. Our study is a retrospective analysis by authors in variable disease pattern of TB Spine operated at an institute using a single posterior approach. Settings and Design: A retrospective case study series in a tertiary level hospital. Aims: The aim of this study is to evaluate the functional and radiological results of an all posterior instrumented approach used as a “universal approach” in tubercular spondylodiscitis of variable presentation. Materials and Methods: The study is from January 2015 to May 2018. Twenty-four of 38 patients met the inclusion criterion with a male: female = 8:16, and mean age 44.26 years. The initial diagnosis of TB was based on clinic-radiologic basis. Their level of affection, number of vertebrae affected, and vertebral body collapse, the kyphosis (preoperative, predicted, postoperative, and final residual) and bony fusion were measured in the preoperative, postoperative, and final X rays. Functional scoring regarding visual analog scale and Frankel neurology grading was done at presentation and follow-up of patients. Histopathological data of all patients were collected and anti-tubercular therapy completed for a period of 1 year with 4 drugs (HRZE) for 2 months and 2 drugs (HR) for rest of period. Statistical Analysis Used: The descriptive data were analyzed by descriptive statistics, and other parameters were calculated using the appropriate statistical tests such as the Student paired t-test for erythrocyte sedimentation rate, visual analog scale score, and kyphosis. Results: The mean number of vertebrae involved was 3.29 ± 0.86 (2–6) with mean vertebral body destruction was 0.616. Preoperatively, the mean kyphosis angle was 22.42° ± 12.56° and was corrected postoperatively to 13.08° ± 11.34° with an average correction of 9.34° (41.66%). At the latest follow-up, there was mean loss of correction of 0.80° resulting in 13.88° of final correction. Bony fusion was achieved in 20 patients (83.33%) cases. Neurological recovery occurred in all patients (100%), and 92% could be ambulatory at 1 year follow-up. There was improvement of visual analog scale from 6.33 ± 1.05 preoperatively to 1.042 ± 0.75 at 3 months of postoperative period. Two patients had bed sore, two had urinary infection, and one had neurological worsening requiring re exploration and cage removal eventually recovering to Frankel E. Two patients died due to unrelated cause. Conclusions: The procedure in safe and has satisfactory results in variable group affection of Pott’s spine including early and late disease, multisegment involvement using pedicle screw fixation with/without cage support.

scholarly journals EFFECTIVENESS OF SPIRULINA MOUTHWASH ON REDUCTION OF DENTAL PLAQUE AND GINGIVITIS: A CLINICAL STUDY

2017 ◽  
Vol 9 (7) ◽  
pp. 136
Author(s):  
Radhika Maniyar ◽  
Umashankar G. K.
Keyword(s):  
Visual Analog Scale ◽  
Dental Plaque ◽  
Rank Test ◽  
Analog Scale ◽  
Mean Values ◽  
Significant Difference ◽  
Intervention Protocol ◽  
The Mean ◽  
The Individual

Objective: The present study evaluated the effectiveness of Spirulina mouthwash on the reduction of dental plaque and gingivitis.Methods: A single-blind clinical trial was conducted among thirty patient’s aged 18-40 y visiting dental college and hospital in Bangalore city. Mouthwash was prepared using 0.5% Spirulina. Intervention protocol consisted of instructing the patients to rinse with 10 ml of mouthwash for 1 minute twice daily for 7 d. Plaque index and Gingival index were used to assess the variables at the baseline and after the intervention. The perception of the individual subjects with regard to the use of mouthwash was assessed using 10 cm long visual analog scale (VAS). Statistical analysis was carried out using Wilcoxon signed rank test for mean pre and post plaque and gingival scores respectively. Descriptive statistics was performed for VAS questionnaireResults: The results showed a highly significant difference (p<0.001) between the mean plaque scores at the baseline (2.16±0.34) and at the follow up (1.27±0.46). The mean gingival scores at the baseline (1.86±0.38) and at the follow-up (1.05±0.43) also showed a highly significant difference (p<0.001). Regarding the Visual Analog Scale, the mean values of 5 or greater than suggested the responses to be favourable as the values were reflectedConclusion: The study showed that Spirulina mouthwash resulted in significant reduction in dental plaque and gingivitis. Also, the mouthwash was convenient to use without any adverse effects. Hence, the use of herbal mouth rinses such as Spirulina should be supported.

Coverage of Painful Peripheral Nerve Neuromas with Vascularized Soft Tissue: Method and Results

2005 ◽  
Vol 56 (suppl_4) ◽  
pp. ONS-369-ONS-378 ◽  
Author(s):  
Kartik G. Krishnan ◽  
Thomas Pinzer ◽  
Gabriele Schackert
Keyword(s):  
Spinal Cord ◽  
Soft Tissue ◽  
Peripheral Nerve ◽  
Visual Analog Scale ◽  
Soft Tissue Coverage ◽  
Spinal Cord Stimulator ◽  
Analog Scale ◽  
Before And After ◽  
The Mean

Abstract OBJECTIVE: Our goals are to describe a method of treating painful peripheral nerve neuromas by means of vascularized tissue coverage, report the results in seven patients, and discuss the indications for this treatment modality. An analysis of pain, functionality of the affected body part, professional activities of the patients, and medications before and after surgery is presented. METHODS: Seven male patients (mean age, 45.1 yr) with posttraumatic nerve injuries, who had developed painful stump neuromas or neuromas-in-continuity, and who had unsuccessfully undergone several treatment procedures, were selected for the surgery described here. The operation included resection of the stump neuroma (four patients) or neurolysis of the neuroma-in-continuity (three patients) and coverage of the nerve with a vascularized fascial, fasciocutaneous, or perforator flap (three pedicled regional flaps and four free flaps). A modified quadruple visual analog scale was used to quantify pain before and after surgical treatment. The mean follow-up was 16.6 months. RESULTS: The mean values of the quadruple visual analog scale (pain now/typically/at its best/at its worst) before surgery were 6.5/6.5/4.7/7.9. These values changed to 0.3/0.4/0/0.9 at a mean follow-up of 16.6 months after surgery. Five patients returned to their original profession, one receives a pension, and one began a less demanding job after undergoing surgery. Six of the seven patients received opioids before surgery (one had a spinal cord stimulator). After surgery, all patients stopped taking regular pain killers and the spinal cord stimulator was deactivated in one; two patients still take nonsteroidal anti-inflammatory drugs occasionally, but not on a regular basis. CONCLUSION: Vascularized soft tissue coverage of painful peripheral nerve neuromas seems to be an effective and attractive, but also complex, method of treatment. This option may be considered and reserved for patients who have already undergone several pain treatment modalities without success.

scholarly journals Comparative Analysis of Periodontal Pain Using Two Different Orthodontic Techniques, Fixed Multibrackets and Removable Aligners: A Longitudinal Clinical Study with Monthly Follow-Ups for 12 Months

2021 ◽  
Vol 11 (24) ◽  
pp. 12013
Author(s):  
Silvia Alcón ◽  
Adrián Curto ◽  
Mario Alvarado ◽  
Alberto Albaladejo ◽  
Daniele Garcovich ◽  
...  
Keyword(s):  
Clinical Study ◽  
Visual Analog Scale ◽  
Study Groups ◽  
Analog Scale ◽  
Pain Scores ◽  
Patient Reported ◽  
Maximum Pain ◽  
Conventional Brackets ◽  
Longitudinal Clinical Study

The aim of this study was to evaluate the perception of periodontal pain in patients treated with either fixed multibrackets or removable alignment systems with a monthly follow-up over a period of twelve months. Materials and Methods: This longitudinal clinical study comprised a sample of 140 patients (72 women; 68 men) divided into two groups of 70 patients each: the bracket group (BG) with conventional fixed brackets using the MBT technique with a 0.022″ slot and the Invisalign group (IG) with aligners (Invisalign). The visual analog scale (VAS) was used to quantify patient-reported pain. Pain analysis was conducted monthly at 4 (T1), 8 (T2), and 24 h (T3) post-follow-up as well as at 2 (T4), 3 (T5), 4 (T6), 5 (T7), 6 (T8), and 7 days (T9) post-follow-up during the first twelve months after starting orthodontic treatment. Results: Statistically significant differences (p < 0.05) were observed between both study groups in the mean pain scores on the visual analog scale (VAS) during the twelve-month follow-up period, except for during the eighth month of treatment. In the first month, the group with conventional brackets reported higher pain scores. From the second month onwards, we observed that patients with aligners described a higher level of pain compared to the group of patients with conventional brackets. In both experimental groups, though at different evaluation periods, we found that the peak of maximum pain occurred between 24 and 48 h (T3–T4) after monthly follow-up appointments; from this point, the pain decreased until reaching minimum values from the fifth day onwards (T7). Conclusions: In the first month of treatment, the patients with conventional fixed multibrackets reported the highest levels of pain compared to those with removable aligners. From the second month on, this trend changed. The patients with removable aligners reported the highest levels of pain. Therefore, the orthodontic system used influenced the perception of pain in patients.

Outcomes of ulnotriquetral split tear repair: a report of 96 patients

2019 ◽  
Vol 44 (10) ◽  
pp. 1036-1040 ◽  
Author(s):  
Nicholas J. Clark ◽  
Nicholas Munaretto ◽  
David Ivanov ◽  
Richard A. Berger ◽  
Sanjeev Kakar
Keyword(s):  
Range Of Motion ◽  
Visual Analogue Scale Pain ◽  
Level Of Evidence ◽  
Superficial Infection ◽  
Excellent Outcome ◽  
Pain Scores ◽  
Analogue Scale Pain ◽  
The Mean ◽  
And Function

Ninety-six wrists (56 right and 40 left) in 96 patients (36 males and 60 females, mean age 38, range 15–77 years) underwent repair of ulnotriquetral ligament split tears between 2007 and 2016. Mayo wrist scores, visual analogue scale pain scores, and objective measures including grip strength and range of motion were obtained. Patients were assessed after a mean follow-up of 21 months (range 6–112 months). Ulnotriquetral split tear repair resulted in substantial improvements in pain and function. The mean Mayo wrist score improved from 57 preoperatively to 81 postoperatively, with 84% of patients achieving a good or excellent outcome. Pain scores decreased from 5.8 to 1.2. Grip improved from 25 kg to 29 kg. There was no significant change in range of motion of the wrist. Complications were noted in eight patients, with three experiencing continued pain, four with dysaesthesia of the dorsal sensory ulnar nerve, and one superficial infection. Arthroscopic ulnotriquetral split tear repair significantly reduced pain and improved Mayo wrist scores. Level of evidence: IV

scholarly journals Long-Term Outcomes of Total Ankle arthroplasty with mobile bearing in 124 ankles, Over eight years of follow-up

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0025
Author(s):  
Yeokgu Hwang ◽  
Kwang Hwan Park ◽  
Seung Hwan Han ◽  
Jin Woo Lee
Keyword(s):  
Visual Analog Scale ◽  
Revision Rate ◽  
Total Ankle Arthroplasty ◽  
Long Term Outcomes ◽  
Analog Scale ◽  
Ankle Arthroplasty ◽  
Patient Reported ◽  
The Mean

Category: Ankle Arthritis Introduction/Purpose: Total ankle arthroplasty (TAA) is increasingly recommended for patients with end-stage ankle osteoarthritis. However, there were few studies which had investigated long-term clinical outcomes with mobile baering system. We analyzed the patient reported results of 124 arthroplasties performed with one type of three-component total ankle prosthesis. This prospective cohort study analyzed long-term outcomes of total ankle arthroplasty with use of the Hintegra prosthesis at one center. Methods: Consecutive patients who received the hintegra prosthesis between September 2004 and December 2009 were enrolled at one large, university hospitals. Patients were annually evaluated clinically, and the patients reported survey with visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) scores, Foot and Ankle Outcome Score (FAOS) and revision rate. Kaplan-Meier survival result showed survival outcomes of TAA in long-term follow-up. Results: One hundred and twenty-four ankles underwent arthroplasty with the Hintegra prosthesis. The mean age of patient at operation time was 64.2 years old (range, 47 to 84 years old). The mean duration of follow-up for all living patients without revision (Eighty-six ankles) was 10.0 ± 1.3 years. The mean change from baseline to final follow-up was -6.7 ± 4.3 points for Visual analog scale, and 26.1 ± 10.3 points for the AOFAS score. . Seven (5.6%) of the ankles required metal component revision at a mean of 2.9 ± 1.8 years (range, 0.5 to 5.8 years). Ten (8%) of the prostheses underwent polyethylene bearing exchange, mostly due to asymmetric wear, at a mean of 2.8 ± 1.8 years (range, 0.1 to 9.1 years). Conclusion: Long term outcomes were good after ankle arthroplasty with the Hintegra prosthesis performed by experienced surgeons, and long-term outcomes demonstrated. The revision rate was substantially higher among the first fifty ankles than among subsequent ankles. Further study to elucidate possible reasons for osteolysis and subjective pain after TAA is warranted.

The Use of Intra-articular Hylan G-F 20 in the Treatment of Symptomatic Osteoarthritis of the Shoulder

2007 ◽  
Vol 35 (6) ◽  
pp. 979-985 ◽  
Author(s):  
Eric Silverstein ◽  
Robin Leger ◽  
Kevin P. Shea
Keyword(s):  
Visual Analog Scale ◽  
Case Series ◽  
Visual Analog Scale Score ◽  
Analog Scale ◽  
Level Of Evidence ◽  
Simple Shoulder Test ◽  
Ucla Score ◽  
Glenohumeral Osteoarthritis ◽  
The Mean

Background While hylan G-F 20 is an approved therapy for the treatment of knee osteoarthritis, there are few reports of its use in shoulder osteoarthritis. Hypothesis Hylan G-F 20 can reduce pain and improve function in patients with glenohumeral osteoarthritis. Study Design Case series; Level of evidence, 4. Methods Thirty consecutive patients with idiopathic glenohumeral osteoarthritis who failed to respond to standard conservative measures were enrolled. Patients received 3 weekly intra-articular hylan G-F 20 injections in their affected shoulder and completed a visual analog scale for pain, the UCLA score, and the Simple Shoulder Test at baseline and at 1, 3, and 6 months after the third injection. Results Of the 30 patients, 3 withdrew during the washout period before treatment; the remaining patients (17 men and 10 women) had an average age of 62 years. The mean baseline visual analog scale score was 54, UCLA score was 15.7, and Simple Shoulder Test score was 5.7 (of 12 possible “yes” responses). At the 6-month follow-up, hylan G-F 20 significantly improved visual analog scale (mean 30, P < .001), UCLA (mean 24, P < .001), and Simple Shoulder Test (7.6 “yes” responses, P < .001) scores. More patients slept comfortably after treatment (56%) versus before treatment (15%). Nine patients had a visual analog scale improvement >40 points after 6 months. No device-related adverse events were observed. Conclusion Hylan G-F 20 may have a beneficial therapeutic effect on some symptomatic patients with glenohumeral osteoarthritis.

scholarly journals Arthroscopic Abrasion Arthroplasty Is Not Superior to Ligament Reconstruction and Tendon Interposition for Thumb Carpometacarpal Arthritis

Hand ◽  
2018 ◽  
Vol 14 (6) ◽  
pp. 791-796
Author(s):  
Dominik Rog ◽  
Tuna Ozyurekoglu ◽  
Kumar K. Karuppiah
Keyword(s):  
Ligament Reconstruction ◽  
Analog Scale ◽  
Vas Score ◽  
Pain Scores ◽  
The Poor ◽  
The Mean ◽  
Thumb Carpometacarpal ◽  
Tendon Interposition ◽  
Cmc Joint

Background: A few arthroscopic options have been proposed for the treatment of early stages of the arthritis of the thumb carpometacarpal (CMC) joint. The purpose of this study was to compare the results of arthroscopic abrasion arthroplasty with ligament reconstruction and tendon interposition (LRTI). Methods: In this retrospective cohort study, 11 patients who underwent thumb CMC joint arthroscopic abrasion arthroplasty were compared with 15 patients who were randomly selected from a group of 80 LRTI arthroplasty patients during the same study period, with a minimum 1 year follow-up. Preoperative and postoperative evaluations included radiographs and measurements of grip strength, visual analog scale (VAS) pain scores, and Disabilities of the Arm, Shoulder and Hand (DASH) scores. Results: The mean preoperative VAS score in both groups was 6.8. Mean preoperative DASH scores were 61.1 in the arthroscopy group and 67.4 in the LRTI group. Postoperative VAS score at final follow-up was 4.8 in the arthroscopy group and 1.2 in the LRTI group ( P < .05). Postoperative DASH scores 9 months after surgery were 23 for the LRTI group and 55.2 for the arthroscopy group ( P < .05). Eight patients in the arthroscopy group had a second surgery due to persistent pain. Conclusions: Patients undergoing arthroscopic abrasion arthroplasty had high revision rates, higher postoperative pain, and lower patient-rated outcomes than patients undergoing LRTI procedure. The poor results in the arthroscopy group may be secondary to the inherent instability of the CMC joint and lack of use of any biological or artificial interposition material.

MIDTERM OUTCOME AFTER MICROENDOSCOPIC DECOMPRESSIVE LAMINOTOMY FOR LUMBAR SPINAL STENOSIS

Neurosurgery ◽  
2009 ◽  
Vol 65 (1) ◽  
pp. 100-110 ◽  
Author(s):  
Manuel Castro-Menéndez ◽  
Jose A. Bravo-Ricoy ◽  
Roberto Casal-Moro ◽  
Moisés Hernández-Blanco ◽  
Francisco J. Jorge-Barreiro
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Visual Analog Scale ◽  
Visual Analog Scale Score ◽  
Analog Scale ◽  
Oswestry Disability Index Score ◽  
Pain Visual Analog Scale ◽  
The Mean ◽  
Lumbar Spinal

ABSTRACT OBJECTIVE To evaluate the efficacy of radicular decompression in lumbar spinal stenosis using a microendoscopic technique. METHODS This was a longitudinal prospective study of 50 patients with a diagnosis of lumbar spinal stenosis who were treated by microendoscopic decompression using an 18-mm METRx tubular retractor according to the METRx technique (Medtronic Sofamor Danek, Memphis, TN). Twenty of the patients had an additional disc prolapse, and a microendoscopic discectomy was associated with decompressive laminectomy. The results were evaluated using the visual analog scale pain score, Oswestry Disability Index score, patient satisfaction questionnaire, and modified Macnab classification. RESULTS The average age of the patients was 56 years; 29 (58%) were men and 21 (42%) were women. The most commonly affected level was L4–L5 (64%). The mean surgical intervention time was 94.3 (± 14.3) minutes. Mean postoperative hospital stay was 3.16 (± 2.3) days. The follow-up time after surgery was 4 years (48 ± 6.6 months; range, 24–72 months). We obtained good or excellent results in 72% of patients, achieving good subjective satisfaction in 68% of the patients. The mean decrease in the Oswestry Disability Index score was 30.23 (± 24.29), the mean decrease in the leg pain visual analog scale score was 6.02 (± 2.57), and the mean decrease in the lumbar pain visual analog scale score was 0.84 (± 2.06). Adjusted mean differences were in all cases statistically significant (P &lt;0.05). CONCLUSION Data indicate that, in our experience, on midterm follow-up, microendoscopic laminectomy decompression is an effective technique for the treatment of lumbar spinal stenosis.

RADIOSURGERY IN THE TREATMENT OF SPINAL METASTASES

Neurosurgery ◽  
2009 ◽  
Vol 65 (6) ◽  
pp. 1052-1062 ◽  
Author(s):  
Jason P. Sheehan ◽  
Christopher I. Shaffrey ◽  
David Schlesinger ◽  
Brian J. Williams ◽  
Vincent Arlet ◽  
...  
Keyword(s):  
Scale Score ◽  
Visual Analog Scale ◽  
Oswestry Disability Index ◽  
Spinal Metastases ◽  
Visual Analog Scale Score ◽  
Analog Scale ◽  
Metastatic Tumors ◽  
Oswestry Disability Index Score ◽  
The Mean

Abstract OBJECTIVE The effectiveness and limitations of spinal radiosurgery using a helical TomoTherapy system for the treatment of spinal metastases are reviewed in this article. METHODS This is a retrospective review of patients who underwent stereotactic radiosurgery for spinal metastases between July 2004 and December 2007. Radiographic follow-up consisted of magnetic resonance imaging to assess tumor growth control as well as pre- and posttreatment x-rays, which were used to measure changes in segmental angulation and deformity. Clinical performance was assessed using the Karnofsky Performance Scale, Oswestry Disability Index, and visual analog scale. RESULTS Forty patients were treated for 110 metastatic tumors (range, 1–6 tumors per patient). The mean age at the time of radiosurgical treatment was 67 years (age range, 35–81 years). Twenty-three patients (57.5%) had undergone previous surgical resection. Pain was the most common presenting symptom, seen in 32 patients (80%). The mean Oswestry Disability Index score at presentation was 43 (range, 20–90), and the mean visual analog scale score was 6.2 (range, 0–10). The mean radiosurgical dose to the tumor was 17.3 Gy (range, 10–24 Gy). At a mean follow-up duration of 12.7 months (range, 4–32 months), decreased or stable tumor volume was seen in 90 (82%) of the tumors treated. There was improvement in pain in 34 patients (85%). The mean postradiosurgical Oswestry Disability Index score was 25 (range, 10–90), whereas the postradiosurgical visual analog scale score was 3.2 (range, 0–9). Progression of kyphosis was the most common radiographic sequela, experienced by 73% of patients alive at 12 months, with a mean change in angulation of 7.3 ± 4.5 degrees. CONCLUSION Radiosurgery is effective as either primary or adjunctive treatment of metastatic tumors of the spine.

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