Tominaga Hiroyuki, Kawamura Ichiro, Shimada Hirofumi, Sasaki Hiromi, Taniguchi Noboru, Shiratani Yuki, Suzuki Akinobu, Terai Hidetomi, Shimizu Takaki, Kakutani Kenichiro, Kanda Yutaro, Ishihara Masayuki, Paku Masaaki, Takahashi Yohei, Funayama Toru, Miura Kousei, Shirasawa Eiki, Inoue Hirokazu, Kimura Atsushi, Iimura Takuya, Moridaira Hiroshi, Nakajima Hideaki, Watanabe Shuji, Akeda Koji, Takegami Norihiko, Nakanishi Kazuo, Sawada Hirokatsu, Matsumoto Koji, Funaba Masahiro, Suzuki Hidenori, Funao Haruki, Oshigiri Tsutomu, Hirai Takashi, Otsuki Bungo, Kobayakawa Kazu, Uotani Koji, Manabe Hiroaki, Tanishima Shinji, Hashimoto Ko, Iwai Chizuo, Yamabe Daisuke, Hiyama Akihiko, Seki Shoji, Goto Yuta, Miyazaki Masashi, Watanabe Kazuyuki, Nakamae Toshio, Kaito Takashi, Nakashima Hiroaki, Nagoshi Narihito, Kato Satoshi, Imagama Shiro, Watanabe Kota, Inoue Gen, Furuya Takeo
Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
Department of Orthopaedic Surgery, Kagoshima City Hospital, 37-1 Kamiaratacho, Kagoshima, 890-8760, Japan.
Sci Rep. 2025 Jul 29;15(1):27684. doi: 10.1038/s41598-025-12485-7.
The usefulness of spine stabilization for treating metastatic spinal tumors with tumor-induced instability has been reported. However, no reports have prospectively evaluated the effectiveness of adding posterior decompression to stabilization surgery for improving symptoms. This multicenter prospective study aimed to determine whether adding posterior decompression to spine stabilization surgery for metastatic spinal tumors affects postoperative outcomes and complications. A total of 263 patients who underwent spine stabilization with (n = 189) or without (n = 74) decompression were analyzed. Patient demographics, the Spinal Instability Neoplastic Score (SINS), and the Epidural Spinal Cord Compression (ESCC) score were recorded. The outcomes were assessed preoperatively and at 1 and 6 months postoperatively in terms of neurological status, the Barthel Index, the EQ-5D-5 L, and the visual analog scale (VAS). Decompression was primarily performed in patients with severe neurological deficits and high-grade ESCC. Both groups showed postoperative improvement. Propensity score matching was applied to adjust for baseline differences. After matching, there were no significant differences in functional improvement between the decompression and nondecompression groups, and the complication rates were comparable. In matched patients presenting primarily with spinal instability and pain, the addition of decompression did not appear to confer a significant functional benefit within 6 months postoperatively.
脊柱稳定术治疗伴有肿瘤诱导性不稳定的转移性脊柱肿瘤的有效性已有报道。然而，尚无前瞻性评估在稳定手术中加用后路减压术改善症状有效性的报告。这项多中心前瞻性研究旨在确定在转移性脊柱肿瘤的脊柱稳定手术中加用后路减压术是否会影响术后结局和并发症。对总共263例行脊柱稳定术的患者进行了分析，其中189例进行了减压，74例未进行减压。记录了患者的人口统计学数据、脊柱不稳定肿瘤评分（SINS）和硬膜外脊髓压迫（ESCC）评分。在术前、术后1个月和6个月对神经功能状态、Barthel指数、EQ-5D-5L和视觉模拟量表（VAS）进行评估。减压主要针对有严重神经功能缺损和高级别ESCC的患者。两组术后均有改善。采用倾向评分匹配法来调整基线差异。匹配后，减压组和非减压组在功能改善方面无显著差异，并发症发生率相当。在主要表现为脊柱不稳定和疼痛的匹配患者中，术后6个月内加用减压术似乎并未带来显著的功能益处。
