The article presents a study on the management of metastatic epidural spinal cord compression (MESCC), a condition in which spinal metastases result in spinal instability and neurological deficits. The study retrospectively evaluated 53 patients with MESCC, assessing their neurological status, pain status, and survival rates. The results showed that prompt surgical treatment followed by oncological treatment led to significant neurological recovery, prolonged survival, pain relief, and improved quality of life, particularly in patients with a short survival time. The study also highlighted the importance of considering radiotherapy as part of the treatment plan. The findings emphasize the advancements in surgical techniques and instrumentation in effectively managing MESCC
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most advanced spinal facility in UK
Published article
CONCLUSIONS: Common symptoms of MESCC include spinal pain and neurological deficit below the level of the injury. Prompt surgical treatment followed by oncological treatment leads to significant neurological recovery, more prolonged survival, pain relief, and improved quality of life in patients with a short survival time. Oncological treatments, including radiotherapy (RT), should be recommended after surgical treatment.
Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
Eur Rev Med Pharmacol Sci. 2023 Jul;27(13):6121-6131. doi: 10.26355/eurrev_202307_32968.ABSTRACTOBJECTIVE: Spinal metastases may only affect the bone tissue and result in spinal instability or may additionally result in epidural compression, leading to neurological deficits. Surgery has emerged as a popular method in treating metastatic epidural spinal cord compression (MESCC) due to the advances in surgical techniques,
Eur Rev Med Pharmacol Sci. 2023 Jul;27(13):6121-6131. doi: 10.26355/eurrev_202307_32968.
ABSTRACT
OBJECTIVE: Spinal metastases may only affect the bone tissue and result in spinal instability or may additionally result in epidural compression, leading to neurological deficits. Surgery has emerged as a popular method in treating metastatic epidural spinal cord compression (MESCC) due to the advances in surgical techniques and instrumentation. In this study, we evaluated patients with MESCC regarding neurological status, pain status, and survival rates, and presented our experience managing MESCC.
PATIENTS AND METHODS: Clinical and radiographic records of 53 patients diagnosed with MESCC between January 2011 and March 2017 were retrospectively evaluated. The study included patients with a pathological diagnosis of primary cancer, those who complained of spinal metastasis, and those who had indications of MESCC on Magnetic Resonance Imaging (MRI). Bone structure and spinal stability were evaluated using assessed Computed Tomography (CT), and metastatic spread was considered using assessed Positron Emission Tomography (PET) in suitable cases. For each patient, the presence of a tumor compressing the spinal cord, age, gender, preoperative, and postoperative American Spinal Injury Association scores (ASIA), Tokuhashi prognostic score (TPS), affected spinal segment, pathological diagnosis, preoperative, and postoperative Visual Analog Scale (VAS), the status of spinal stability, follow-up period, and complications were evaluated.
RESULTS: Forty-five patients (82.2% of them were women) underwent surgery with a mean age of 58.29 ± 15.14 years. The most frequent type of primary tumor was multiple myeloma (33.9%), followed by lung (24.6%), gastric (7.5%), and prostate (5.7%). The most common site of metastasis was the thoracic region (43.4%), followed by lumbar (24.5%), multiple (24.5%), and cervical (5.7%). The analysis indicated that a significant difference was found between the survival rates of the TPS categories.
CONCLUSIONS: Common symptoms of MESCC include spinal pain and neurological deficit below the level of the injury. Prompt surgical treatment followed by oncological treatment leads to significant neurological recovery, more prolonged survival, pain relief, and improved quality of life in patients with a short survival time. Oncological treatments, including radiotherapy (RT), should be recommended after surgical treatment.
PMID:37458664 | DOI:10.26355/eurrev_202307_32968
The London Spine Unit : most advanced spinal facility in UK
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Treatment and outcomes of patients with metastatic spinal cord compression: a double-center study
