Neurological recovery after posterior spinal surgery in patients with metastatic epidural spinal cord compression

Noriyuki Watanabe, Yoshihisa Sugimoto, Masato Tanaka, Tetsuro Mazaki, Shinya Arataki, Tomoyuki Takigawa, Masaki Kataoka, Toshiyuki Kunisada, Toshifumi Ozaki

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Metastatic epidural spinal cord compression (MESCC) is a common complication in patients with a malignant tumor, but it is difficult to decide the proper time to perform the necessary surgery. Here we analyzed the prognostic factors for postoperative walking ability. We retrospectively reviewed the cases of 112 MESCC patients treated surgically at our institute and divided them into ambulatory (n= 88) and non-ambulatory (n=24) groups based on their American Spinal Injury Association (ASIA) Impairment Scale grades at the final follow-up. We also classified the patients preoperatively using the revised Tokuhashi score. We assessed the correlation between preoperative or intraoperative factors and postoperative walking ability in both groups. Of the 10 patients classified preoperatively as grade A or B, 2 (20%) were ambulatory at the final follow-up. Of the 102 patients classified preoperatively as grade C, D or E, 86 (84%) were ambulatory at the final follow-up (p < 0.001). There were no significant differences between the groups in the average total Tokuhashi score. Our analysis revealed that the severity of paralysis significantly affects neurological recovery in patients with MESCC. Patients with MESCC should receive surgery before the preoperative ASIA Impairment Scale grade falls below grade C.

Original languageEnglish
Pages (from-to)449-453
Number of pages5
JournalActa medica Okayama
Volume70
Issue number6
Publication statusPublished - 2016

Keywords

  • American spinal injury association impairment scale
  • Metastatic epidural spinal cord compression
  • Prognostic factor
  • Tokuhashi score
  • Walking ability

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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