Surgical complications and re-operation rates in spinal metastases surgery: a systematic review
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REVIEW ARTICLE
Surgical complications and re-operation rates in spinal metastases surgery: a systematic review Ahmad M. Tarawneh1 · Dritan Pasku1 · Nasir A. Quraishi1 Received: 21 June 2020 / Revised: 10 September 2020 / Accepted: 20 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective The goal of this study was to review the incidence of complications and unplanned re-operations after surgery for metastatic spinal tumors. Background The spinal column is the most common osseous site for metastatic spread. The goals of the treatment of spinal metastases are largely palliative. The surgical aims include establishing a diagnosis, providing stability, relieving neurological compression and deterioration, decreasing pain and increasing patient independence. Patients with spinal metastases who undergo surgery are considered high risk, with higher morbidity and mortality rates. Materials and methods A systematic review was undertaken; PubMed and Embase databases were searched between (2010– 2020) for relevant publications in English language with the following search items: metastasis OR metastases AND spine AND surgery AND complications OR revision. Using a standard PRISMA template, 2293 articles were identified. Full-text articles of interest were assessed for inclusion criteria of greater than 30 patients. Results A final number of 19 articles fully met the search criteria. Four were level II evidence, and the remaining were level III/IV. Surgical site infection 6.5% (135/2088) was reported as the main complication following surgery for spinal metastases followed by neurological deterioration 3.3% (53/1595) and instrumentation failure 2.0% (30/1501). Re-operation rate was 8.3% (54/651), with SSI (27.8%) being the most common reason for revision surgery. Conclusion Patients with spinal metastases frequently present with complex therapeutic challenges requiring multidisciplinary team assessment. Surgical site infection (6.5%) was the main reason for a re-operation in patients undergoing surgery for spinal metastases. Keywords Spine metastasis · Spine metastases · Complications · Revision
Introduction The spinal column is the most common osseous site for metastatic spread [1] with more than one-third of cancer patients have metastatic involvement of their spine [2]. Not all spinal metastases lead to neurological compromise. It is estimated that 20% of patients with spinal metastases will develop spinal cord compression [3, 4]. Additionally, patients may present with symptoms related to pathological vertebral fractures [5].
* Ahmad M. Tarawneh [email protected] 1
Centre for Spinal Studies and Surgery, Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
Treatment for metastatic bone disease is often palliative [6]. Surgical intervention for patients with metastatic spinal tumors is indicated in patients with pain, instability or neurological compromise who have a life expectancy exceeding three months, according to the National I
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