Posterior decompression and spine stabilization for metastatic spinal cord compression in the cervical spine. A matched pair analysis

Purpose: This study aims to compare clinical outcome of cervical spine metastasis with those of thoracic and lumbar spine metastasis after surgery for metastatic spinal cord compression (MSCC).

Patients and methods: Data from nineteen patients with cervical spine metastasis were matched to thirty-eight patients with thoracic spine metastasis and thirty-eight patients with lumbar spine metastasis from a cohort of 183 patients with MSCC treated with posterior decompression and spine stabilization. Three groups were matched for eleven potential prognostic characteristics, and at least nine of eleven characteristics should match between the matched patients.

Results: Deterioration of motor function was observed in 37% patients with cervical spine metastasis, 18% patients with thoracic spine metastasis, and 13% patients with lumbar spine metastasis after surgery (P = 0.02). Postoperative median survival was 11.5 months for cervical spine metastasis, 10.9 months for thoracic spine metastasis, and 10.7 months for lumbar spine metastasis (P = 0.64). Surgery-related complications occurred in 18.9% of all patients and showed no significant difference between the three groups (P = 0.63). Each group experienced improvement in pain outcome when compared between pre- and post-operative pain scores (P < 0.01), while the differences had no significance between the three groups (P > 0.05).

Conclusions: MSCC in cervical spine is less likely to improve or maintain motor function as compared with MSCC in thoracic and lumbar spine after surgery. However, its clinical outcomes appear similar to those of thoracic and lumbar spine metastasis in terms of postoperative survival, surgery-related complication, and pain outcome.