Introduction: Metastases to the spine occur from a variety of primary malignancies. Surgery on these patients can be challenging with a substantial risk of complications. We present a single-center experience of 189 consecutive patients who underwent surgery for spinal metastases, and share our insights regarding complications.
Methods: Charts of 189 patients who underwent surgery for spinal metastases over 5 years from October 2011 through February 2017 were reviewed for complications and possible contributing factors. A multivariate analysis was performed for patient demographic and surgical parameters that predict complications.
Results: Complications were identified in 20% of all patients who underwent surgery for spine metastases. Medical complications included: urinary tract infection, 10%; deep vein thrombosis/pulmonary embolism, 5%; pneumonia, 3% and myocardial infarction, 1%. Surgical complications included: wound infection, 3%; and new neurologic deficit, 2%. Average thirty-day survival was 87%. Average ninety-day survival was 65%. Age > 65, prior radiation, and multiple metastases were all predictive of complications at a statistically significant threshold of p < 0.05.
Conclusions: Surgery for spinal metastases is associated with a relatively high complication rate. Medical complications are more common than surgical complications. Age > 65, prior radiation, and multiple metastases were all predictive of complications. Optimization of co-morbid conditions by a multidisciplinary team may help reduce medical complications associated with surgery for spinal metastases.
Patient Care: Our findings will help providers reduce complication rates associated with surgery for patients with spinal metastases.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) describe the most relevant complication rates for patients undergoing surgery for spinal metastases, and 2) discuss the relative implications of post-operative management options on complication rates.