MORTALITY AFTER SURGICAL DECOMPRESSION & STABILISATION FOR METASTATIC EXTRADURAL SPINAL COMPRESSION скачать в хорошем качестве

MORTALITY AFTER SURGICAL DECOMPRESSION & STABILISATION FOR METASTATIC EXTRADURAL SPINAL COMPRESSION

THE MORTALITY OUTCOME FOLLOWING SURGICAL DECOMPRESSION AND STABILISATION FOR METASTATIC EXTRADURAL SPINAL COMPRESSION IN A DGH SETTING P. Foster, H. De Waal, A. Subramanian, Y.Leung, P.Thorpe, P.Madhavan, D.Thavarajah Somerset NHS Foundation Trust, Musgrove Park Hospital, Parkfield Drive, Taunton, TA1 5DA We wanted to determine the outcome (time to mortality) of patients that we had operated on for extradural metastatic spinal cord/ cauda equina compression. This would help us validate our selection of patients for these surgical procedures. We looked at 69 operated patients over a 4 year period, operated on for acute metastatic cord/cauda equina compression by any one of 5 spinal surgeons following discussion with the patient and oncologist. The Tokuhashi score, time to surgery from presentation, the death rate and the time (days) to death were recorded. Surgical procedures were most commonly posterior decompression and instrumented fusion. Of 171 patients referred to the spinal service 69 (40%) had surgery. Mean time of referral to surgery was 15.02 days (1-133 days). The mortality rate of operated patients was 21 patients (30.4%) at time of writing. Mean time to death of 728 days (18-2396 days) between surgery and death. Lung and renal primaries survived the shortest time. Oncological management now offers several lines of treatment modalities for different tumours. We have historically used the Tokuhashi score to guide management. Our unit data provides validation of that score with a mean survival of 2 years.