Skip Navigation LinksHome > March 2011 - Volume 68 - Issue 3 > Predictors of Survival After Surgical Treatment of Spinal Me...
doi: 10.1227/NEU.0b013e318207780c
Research-Human-Clinical Studies

Predictors of Survival After Surgical Treatment of Spinal Metastasis

Arrigo, Robert T BS*§; Kalanithi, Paul MD†§; Cheng, Ivan MD‡; Alamin, Todd MD‡; Carragee, Eugene J MD‡; Mindea, Stefan A MD†; Park, Jongsoo MD†; Boakye, Maxwell MD, FACS†§

Collapse Box


BACKGROUND: Surgery for spinal metastasis is a palliative treatment aimed at improving patient quality of life by alleviating pain and reversing or delaying neurologic dysfunction, but with a mean survival time of less than 1 year and significant complication rates, appropriate patient selection is crucial.

OBJECTIVE: To identify the most significant prognostic variables of survival after surgery for spinal metastasis.

METHODS: Chart review was performed on 200 surgically treated spinal metastasis patients at Stanford Hospital between 1999 and 2009. Survival analysis was performed and variables entered into a Cox proportional hazards model to determine their significance.

RESULTS: Median overall survival was 8.0 months, with a 30-day mortality rate of 3.0% and a 30-day complication rate of 34.0%. A Cox proportional hazards model showed radiosensitivity of the tumor (hazard ratio: 2.557, P < .001), preoperative ambulatory status (hazard ratio: 2.355, P = .0001), and Charlson Comorbidity Index (hazard ratio: 2.955, P < .01) to be significant predictors of survival. Breast cancer had the best prognosis (median survival, 27.1 months), whereas gastrointestinal tumors had the worst (median survival, 2.66 months).

CONCLUSION: We identified the Charlson Comorbidity Index score as one of the strongest predictors of survival after surgery for spinal metastasis. We confirmed previous findings that radiosensitivity of the tumor and ambulatory status are significant predictors of survival.

Copyright © by the Congress of Neurological Surgeons


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.