Spine Service, Department of Trauma and Orthopaedic Surgery, Galway University Hospitals, Ireland.
Spine Service, Department of Trauma and Orthopaedic Surgery, Galway University Hospitals, Ireland.
Surgeon. 2022 Oct;20(5):328-333. doi: 10.1016/j.surge.2021.08.007. Epub 2021 Sep 22.
Bone is the third most common site of metastatic cancer, of which the spine is the most frequently involved. As metastatic cancer prevalence rises and surgical techniques advance, operative intervention for spinal metastases is expected to rise. In the first operative cohort of spinal metastasis in Ireland, we describe the move towards less invasive surgery, the causative primary types and post-operative survival.
This is a retrospective cohort study of all operative interventions for spinal metastasis in a tertiary referral centre over eight years. Primary spinal tumours and local invasion to the spine were excluded. Median follow up was 1895 days.
225 operative procedures in 196 patients with spinal metastasis were performed over eight years. Average cases per year increased form 20 per year to 29 per year. Percutaneous procedures became more common, accounting for the majority (53%) in the final two years. The most common primary types were breast, myeloma, lung, prostate and renal. Overall survival at 1 year was 51%. Primary type was a major determinant of survival, with breast and the haematological cancers demonstrating good survival, while lung had the worst prognosis.
This is the first descriptive cohort of operative interventions for spinal metastasis in an Irish context. Surgery for spinal metastasis is performed at an increasing rate, especially through minimally-invasive means. The majority of patients survive for at least one year post-operatively. Prudent resource planning is necessary to prepare for this growing need.
骨骼是转移性癌症的第三大常见部位，其中脊柱是最常受累的部位。随着转移性癌症发病率的上升和手术技术的进步，预计脊柱转移的手术干预将会增加。在爱尔兰的第一组脊柱转移手术中，我们描述了向微创手术的转变、常见的原发性肿瘤类型以及术后生存情况。
这是一项对八年内在三级转诊中心接受脊柱转移手术的所有患者进行的回顾性队列研究。排除了原发性脊柱肿瘤和脊柱局部侵袭。中位随访时间为 1895 天。
在八年期间，对 196 名脊柱转移患者进行了 225 次手术。每年的平均手术例数从每年 20 例增加到每年 29 例。经皮手术变得更加常见，在最后两年占大多数（53%）。最常见的原发性肿瘤类型是乳腺癌、骨髓瘤、肺癌、前列腺癌和肾癌。1 年总生存率为 51%。原发性肿瘤类型是生存的主要决定因素，乳腺癌和血液系统癌症的生存情况良好，而肺癌的预后最差。
这是爱尔兰首例描述性的脊柱转移手术队列研究。脊柱转移的手术治疗率正在上升，尤其是通过微创手术方式。大多数患者术后至少存活一年。需要进行谨慎的资源规划，以满足这种不断增长的需求。
