SynthesisSpine2012
Clinical outcome of metastatic spinal cord compression treated with surgical excision ± radiation versus radiation therapy alone: a systematic review of literature.
Synthesis in Spine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
51 citing papers in PubMed, 3 syntheses or guidelines pooled it, 154 citations in OpenAlex.
- Prognostic factors and outcomes of surgical intervention for patients with spinal metastases secondary to lung cancer: an update systematic review and meta analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Pooled it
- Sarcopenia in Patients With Spinal Metastasis: A Systematic Review and Meta-Analysis of Retrospective Cohort Studies.Frontiers in oncology · 2022Pooled it
- Interventions for the treatment of metastatic extradural spinal cord compression in adults.The Cochrane database of systematic reviews · 2015Pooled it
- Phase 1/2 trial of single-session stereotactic body radiotherapy for previously unirradiated spinal metastases.Cancer · 2012Trial
- Residence in a rural setting is associated with lower five-year survival rates in patients that undergo spine surgery for breast cancer metastatic to the spine: A propensity matched analysis.North American Spine Society journal · 2026Article
- Quality Of Life and Functional Outcomes in Patients with Spinal Metastatic Bone Disease: A Retrospective Observational Study.The archives of bone and joint surgery · 2026Article
- Initial management and disposition of metastatic spinal cord compression in the emergency department: a review of the literature.Annals of medicine · 2025Review
- Article
- Neurological Outcomes and the Need for Retreatments Among Multiple Myeloma Patients With High-Grade Spinal Cord Compression: Radiotherapy vs Surgery.Global spine journal · 2025Article
- Radiation Myelitis Risk After Hypofractionated Spine Stereotactic Body Radiation Therapy.JAMA oncology · 2025Article
- Review
- Development of a clinical prediction score for perioperative complications following metastatic spinal surgery (PERCOM) score.Heliyon · 2024Article
- Article
- Development of Machine-Learning Models to Predict Ambulation Outcomes Following Spinal Metastasis Surgery.Asian spine journal · 2023Article
- Predicting Survival in Patients Presenting With Spinal Epidural Metastases: The Limburg Spinal Metastasis Score.International journal of spine surgery · 2023Article
- Preoperative Predictors of Survival in Patients With Spinal Metastatic Disease.International journal of spine surgery · 2023Article
- Preoperative Embolization of Metastatic Spinal Cord Compression with n-Butyl Cyanoacrylate: Safety and Effectiveness in Limiting Blood Loss.Journal of vascular and interventional radiology : JVIR · 2023Article
- Risk of Myelopathy Following Second Local Treatment after Initial Irradiation of Spine Metastasis.Diagnostics (Basel, Switzerland) · 2023Review
- Acute Metastatic Spinal Cord Compression: Urgent Surgery versus Radiotherapy and Treatment Result Prediction versus Actual Results.Current oncology (Toronto, Ont.) · 2022Article
- Treatment Outcomes in Spinal Metastatic Disease With Indeterminate Stability.Global spine journal · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
STUDY
designSystematic literature review from 1970 to 2007.
objectiveThis study reports the results of a systematic review comparing surgical decompression ± radiation to radiation therapy alone among patients with metastatic spinal cord compression. SUMMARY OF BACKGROUND DATA: Currently, the optimal treatment of metastatic spine lesions is not well defined and is inconsistent. Radiation and surgical excision are both accepted and effective. There appears to be a favorable trend for improved neurological outcome with surgical excision and stabilization as part of the management.
methodsA review of the English literature from 1970 to 2007 was performed in the Medline database using general MeSH terms. Relevant outcome studies for the treatment of metastatic spinal cord compression were selected through criteria defined a priori. The primary outcome was ambulatory capacity. A random effects model was built to compare results between treatment groups, based on calculated proportions from each study.
resultsOf the 1595 articles screened, 33 studies (2495 patients) were selected based on our inclusion and exclusion criteria. Sixty-four percent of the patients who underwent surgical decompression, tumor excision, and stabilization had neurological improvement from nonambulatory to ambulatory status. Twenty-nine percent of the radiation therapy group regained the ability to ambulate after treatment (P < 0.001). Paraplegic patients had a 4-fold greater recovery rate to functional ambulation with surgical intervention than with radiation therapy alone (42% vs. 10%, P < 0.001). Pain relief was noted in 88% of the patients in the surgical studies and in 74% of the patients in studies of radiation therapy (P < 0.001). The overall surgical complication rate was 29%.
conclusionThis systematic review suggests that surgical excision of tumor and instrumented stabilization may improve clinical outcomes compared with radiation therapy alone, with regard to neurological function and pain. However, most data in the current literature are from observational studies, where variations in patient population and treatments cannot be controlled. This compromised our ability to compare the results of both treatments directly.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.