Evidence map›Paper›PMID 35130426›Full record

ArticleNeurospine2022

Steroids in the Management of Preoperative Neurological Deficits in Metastatic Spine Disease: Results From the EPOSO Study.

Anne L Versteeg, Lior M Elkaim, Arjun Sahgal, Laurence D Rhines, Daniel M Sciubba, James M Schuster, Michael G Fehlings, Aron Lazary, Michelle J Clarke, Paul M Arnold and 6 more

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurospine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 10% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Quality of life in patients with malignant spinal cord compression: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023
    Pooled it
  2. Review
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  8. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 13 institutions in 5 countries.

Anne L VersteegDepartment of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
Lior M ElkaimDivision of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada.
Arjun SahgalDepartment of Radiation Oncology, Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, ON, Canada.
Laurence D RhinesDivision of Surgery, Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Daniel M SciubbaDepartment of Neurosurgery, Zucker School of Medicine at Hofstra, Long Island Jewish Medical Center and North Shore University Hospital, Northwell Health, Manhasset, NY, USA.
James M SchusterDepartment of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Michael G FehlingsDivision of Neurosurgery and Spine Program, University of Toronto and Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
Aron LazarySpine Department, National Center for Spinal Disorders and Buda Health Center, Budapest, Hungary.
Michelle J ClarkeDepartment of Neurosurgery, Mayo Clinic, Rochester, MN, USA.
Paul M ArnoldDepartment of Neurosurgery, Carle Foundation Hospital, Urbana, IL, USA.
Chetan BettegowdaDepartment of Neurosurgery, Zucker School of Medicine at Hofstra, Long Island Jewish Medical Center and North Shore University Hospital, Northwell Health, Manhasset, NY, USA.
Stefano BorianiGSpine4 Spine Surgery Division, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Ziya L GokaslanDepartment of Neurosurgery, The Warren Alpert Medical School of Brown University and Rhode Island Hospital and The Miriam Hospital, Providence, Rhode Island, USA.
Charles G FisherDivision of Spine, Department of Orthopaedics, University of British Columbia and Vancouver General Hospital, Vancouver, BC, Canada.
Michael H WeberDepartment of Surgery, McGill University, Montreal, QC, Canada.
AO Spine Knowledge Forum Tumor
McGill University · CANorthwell Health · USBrown University · USBuda Health Center · HUCarle Foundation Hospital · USHospital of the University of Pennsylvania · USIstituto Ortopedico Galeazzi · ITMayo Clinic in Arizona · USSunnybrook Health Science Centre · CAThe University of Texas MD Anderson Cancer Center · USUniversity Health Network · CAUniversity Medical Center Utrecht · NLUniversity of British Columbia · CA

Funding

AOSpineOrthopaedic Research and Education Foundation
6 · The paper itself

Abstract

objectivePatients presenting with neurological deficit secondary to metastatic epidural spinal cord compression (MESCC) are often treated with surgery in combination with high-dose corticosteroids. Despite steroids being commonly used, the evidence regarding the effect of corticosteroids on patient outcomes is limited. The objective of this study was to describe the effect of corticosteroid use on preoperative neurological function in patients with MESCC.

methodsPatients who underwent surgery between August 2013 and February 2017 for the treatment of spinal metastases and received steroids to prevent neurologic deficits were included. Data regarding demographics, diagnosis, treatment, neurological function, adverse events, health-related quality of life, and survival were extracted from an international multicenter prospective cohort.

resultsA total of 30 patients treated surgically and receiving steroids at baseline were identified. Patients had a mean age of 58.2 years (standard deviation, 11.2 years) at time of surgery. Preoperatively, 50% of the patients experienced deterioration of neurological function, while in 30% neurological function was stable and 20% improved in neurological function. Lengthier steroid use did not correlate with improved or stabilized neurological function. Postoperative adverse events were observed in 18 patients (60%). Patients that stabilized or improved neurologically after steroid use showed a trend towards improved survival at 3- and 24-month postsurgery.

conclusionThis study described the effect of steroids on preoperative neurological function in patients with MESCC. Stabilization or improvement of preoperative neurological function occurred in 50% of the patients.

Indexed as

MetastasisNeurological deficitsOutcomesSpinal cord compressionSpineSteroids

Identifiers

PMID35130426
PMCPMC8987562
OpenAlexW4210603097

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.