Management of neoplastic spinal tumors in a spine surgery care unit

• Spine metastases occur in 30 to 50% of cancer patients.
• Management of spine metastasis require a truly multi-disciplinary approach.
• Instability assessment is mandatory.
• Early treatment is suitable to prevent neurological decline.

Background contextSpinal cord compression and fracture are possible complications of spine metastasis and multiple myeloma. Prompt diagnosis and treatment of threatening lesions are likely to reduce the frequency of these dreaded complications.PurposeTo evaluate the proportion of neoplastic spine lesions operated on emergency.Study designRetrospective study.Patient sampleAll patients who underwent palliative surgery for the treatment of a neoplastic spine lesion in our institution between 2005 and 2012.Outcome measuresPercentage of patients who underwent surgery as an emergency for acute fracture or rapid neurological decline.MethodsWe retrospectively reviewed the data of all patients who underwent palliative surgery for the treatment of a neoplastic spine lesion from solid cancer or multiple myeloma, in our institution between January 2005 and December 2012. The study was supported by grant from our institution.ResultsA total of 317 patients were included in the study. There were 166 men and 151 women and the mean age was 57.97 years (range 26–88; SD 12.45). The cancer was known for 224 patients, while the lesion revealed the disease for the other 93 patients. The percentage of patients with known cancer operated as an emergency in our institution decreased significantly between 2005 and 2012 (p = 0.0006).ConclusionDue to the variability of clinical and radiological presentations, best care requires a truly multidisciplinary approach, to offer each patient a prompt and individualized treatment option, which is likely to reduce the incidence of emergency surgeries.