Evidence map›Paper›PMID 40825886›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025

Timing and neurological recovery in metastatic spinal cord compression: short and long-term outcomes of the internal bracing technique.

Paolo Brigato, Giuseppe Francesco Papalia, Gianluca Vadalà, Luisana Sisca, Girolamo Maltese, Fabrizio Russo, Rocco Papalia, Vincenzo Denaro

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Paolo Brigato *Università Campus Bio-Medico, Rome, Italy.
Giuseppe Francesco Papalia *Università Campus Bio-Medico, Rome, Italy.
Gianluca VadalàUniversità Campus Bio-Medico, Rome, Italy. g.vadala@policlinicocampus.it.
Luisana SiscaUniversità Campus Bio-Medico, Rome, Italy.
Girolamo MalteseUniversità Campus Bio-Medico, Rome, Italy.
Fabrizio RussoUniversità Campus Bio-Medico, Rome, Italy.
Rocco PapaliaUniversità Campus Bio-Medico, Rome, Italy.
Vincenzo DenaroUniversità Campus Bio-Medico, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSpinal metastases, affecting up to 40% of cancer patients, often arise from lung, prostate, and breast cancers. Metastatic spinal cord compression (MSCC) causes pain and neurological deficits, requiring timely surgical or radiotherapy interventions. This study evaluates neurological recovery after decompressive surgery and fixation using the "internal bracing" technique in patients with acute MSCC-related deficits, examining overall survival (OS) and its correlation with neurological outcomes.

methodsThis retrospective, single-center study included adult MSCC patients who underwent posterior spinal decompression and instrumentation from 2009 to 2022. Exclusion criteria were age < 21 years, hematologic metastases, cervical spine involvement, anterior surgery, and incomplete data. The primary outcome was postoperative neurological recovery, while secondary outcomes were major complications according to Clavien-Dindo classification, Health-Related Quality of Life (HRQoL) measures and OS. Statistical analysis employed Wilcoxon and ANOVA tests, Kaplan-Meier survival analysis and multivariate analysis (p < 0.05).

resultsThe study involved 34 patients (mean age 58.8 ± 12.6 years), with lung cancer as the most common primary tumor (44.2%). The mean time from symptom onset to surgery was 47 ± 40.2 h. Surgery included decompression and instrumentation with sublaminar hooks and rods, averaging 123 ± 36 min operative time and 260 ± 140 mL blood loss. Postoperative neurological improvement was significant (Frankel score, p = 0.002). No surgical site complications occurred, while systemic complications were noted in 16 patients, all minor (< IIIB). The mean European Quality of Life-5 Dimensions (EQ-5D) score significantly improved from 0.52 ± 0.20 preoperatively to 0.68 ± 0.17 postoperatively (p = 0.035). The mean OS was 14.1 months, significantly correlated with postoperative Frankel grades (p = 0.049). Kaplan-Meier survival curves further confirmed that earlier surgical intervention was associated with improved OS.

conclusionPosterior decompression with the "internal bracing" technique showed satisfactory outcomes in neurological recovery and pain management. Early intervention improved outcomes, with neurological function influencing long-term survival.

Indexed as

Decompression, SurgicalSpinal Cord CompressionSpinal NeoplasmsAdultAgedBracesFemaleHumansLung NeoplasmsMaleMiddle AgedPostoperative ComplicationsQuality of LifeRecovery of FunctionRetrospective StudiesTime FactorsDecompressive surgeryFrankel gradeMetastatic spinal cord compressionNeurological statusQuality of lifeSpinal metastases

Identifiers

PMID40825886

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