The value of palliative surgery for metastatic spinal disease: satisfaction of patients and their families.

BACKGROUND CONTEXT

Although there have been several studies in which the surgical outcomes were evaluated by pain reduction or neurological improvement, there have been few studies focused on the quality of life (QOL) of the patients after the surgery. We considered that the most important consideration in palliative surgery was to respect the wishes of patients and their families, which are likely to be influenced by the patients' QOL for their limited life span.

PURPOSE

To evaluate the value of palliative surgery for spinal metastasis and to identify the factors predicting satisfaction of patients and their families after the surgery.

STUDY DESIGN

Questionnaire-based survey of palliative surgery for spinal metastasis.

PATIENT SAMPLE

Seventy-one consecutive patients who had undergone palliative surgery and their families.

OUTCOME MEASURES

Survival period after surgery, neurological status, ambulatory period, pain scale, and satisfaction of patients and their families.

METHODS

The QOL of the patients after surgery was evaluated by analyzing the satisfaction and related parameters of patients and their families. Questionnaires were sent to 71 consecutive patients who had undergone palliative surgery for spinal metastasis. To identify the factors predicting satisfaction of patients and their families, multivariate logistic regression analyses were performed.

RESULTS

Questionnaires were successfully delivered to 71 patients or their families. Full responses were collected from 37 patients, giving an overall response rate of 52.2%. Overall, 80% of patients were satisfied with the results of the surgical treatment. Age (below 65 years) and neurological improvement after surgery were significant predictors of patient's satisfaction. Pain reduction and the continued survival of the patient were significant predictors of family member's satisfaction.

CONCLUSIONS

These results strongly suggested that palliative surgery is a valuable treatment for metastatic spinal disease. Younger patients were more likely to want active treatment and to seek any functional improvement that contributed to an improved QOL in their limited life span. Pain control and the length of patient survival were important factors for people caring for patients.