Medicina

Journal Browser

► Journal Browser

Update and Overview in Spine Metastases Treatment

Special Issue Editors
Special Issue Information
Keywords
Published Papers

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (25 February 2024) | Viewed by 1918

Share This Special Issue

Special Issue Information

Dear Colleagues,

Spinal metastasis is a common issue causing significant pain and disability in cancer patients. Patients with such an occurrence require prompt medical and surgical attention. A multidisciplinary chemotherapy, radiotherapy, and surgical treatment approach is commonly used. Unfortunately, there are still some “grey areas” in diagnostics and the definition of therapeutic choices for those patients that often delay or impede the best care. Solid decision-making systems must be developed to assist physicians and surgeons in choosing the most appropriate treatment for each patient with spinal metastasis. In particular, the literature still lacks consensus on the timing of surgical management based on neurological presentation and an indication of what patients should treat aggressively and those in which a more conservative approach is recommended. Such lack of consensus is especially true in secondary hospitals where the absence of a multidisciplinary approach often leads to inappropriate care for those patients. Additionally, the post-operative care of those patients and possible complications often lacks precise indications. This Special Issue aims to collect papers describing and analyzing diagnostics tools and algorithms, outcomes and decision-making strategies, and post-treatment palliative care in spine metastases patients. In order to highlight precise indications and avoid misconduct in collecting precious papers on different aspects of spine metastases management covering the state of the art for surgery, radiotherapy and medical and psychokinesis therapy.

Dr. Enrico Giordan
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

spine
metastases
multidisciplinary
surgery
tumors

Published Papers (2 papers)

Download All Papers

Research

Jump to: Other

10 pages, 450 KiB

Open AccessArticle

Effect of Bone Metastasis Cancer Board on Spinal Surgery Outcomes: A Retrospective Study

by Kunihiko Miyazaki, Yutaro Kanda, Yoshitada Sakai, Ryo Yoshikawa, Takashi Yurube, Yoshiki Takeoka, Hitomi Hara, Toshihiro Akisue, Ryosuke Kuroda and Kenichiro Kakutani

Medicina 2023, 59(12), 2087; https://doi.org/10.3390/medicina59122087 - 28 Nov 2023

Viewed by 1106

Abstract

Background and Objectives: Bone metastasis cancer boards (BMCBs) focusing on the management of bone metastases have been gathering much attention. However, the association of BMCBs with spinal surgery in patients with spinal metastases remains unclear. In this retrospective single-center observational study, we aimed to clarify the effect of a BMCB on spinal metastasis treatment. Materials and Methods: We reviewed consecutive cases of posterior decompression and/or instrumentation surgery for metastatic spinal tumors from 2008 to 2019. The BMCB involved a team of specialists in orthopedics, rehabilitation medicine, radiation oncology, radiology, palliative supportive care, oncology, and hematology. We compared demographics, eastern cooperative oncology group performance status (ECOGPS), Barthel index (BI), number of overall versus emergency surgeries, and primary tumors between patients before (2008–2012) and after (2013–2019) BMCB establishment. Results: A total of 226 patients including 33 patients before BMCB started were enrolled; lung cancer was the most common primary tumor. After BMCB establishment, the mean patient age was 5 years older (p = 0.028), the mean operating time was 34 min shorter (p = 0.025), the mean hospital stay was 34.5 days shorter (p < 0.001), and the mean BI before surgery was 12 points higher (p = 0.049) than before. Moreover, the mean number of surgeries per year increased more than fourfold to 27.6 per year (p < 0.01) and emergency surgery rates decreased from 48.5% to 29.0% (p = 0.041). Patients with an unknown primary tumor before surgery decreased from 24.2% to 9.3% (p = 0.033). Postoperative deterioration rates from 1 to 6 months after surgery of ECOGPS and BI after BMCB started were lower than before (p = 0.045 and p = 0.027, respectively). Conclusion: The BMCB decreased the emergency surgery and unknown primary tumor rate despite an increase in the overall number of spinal surgeries. The BMCB also contributed to shorter operation times, shorter hospital stays, and lower postoperative deterioration rates of ECOGPS and BI. Full article

(This article belongs to the Special Issue Update and Overview in Spine Metastases Treatment)

► Show Figures

Figure 1

Other

Jump to: Research

11 pages, 1617 KiB

Open AccessSystematic Review

Systematic Review and Meta-Analysis on Optimal Timing of Surgery for Acute Symptomatic Metastatic Spinal Cord Compression

by Nicola Bresolin, Luca Sartori, Giacomo Drago, Giulia Pastorello, Paolo Gallinaro, Jacopo Del Verme, Roberto Zanata and Enrico Giordan

Medicina 2024, 60(4), 631; https://doi.org/10.3390/medicina60040631 - 13 Apr 2024

Viewed by 543

Abstract

Introduction: Symptomatic acute metastatic spinal epidural cord compression (MSCC) is an emergency that requires multimodal attention. However, there is no clear consensus on the appropriate timing for surgery. Therefore, to address this issue, we conducted a systematic review and meta-analysis of the literature to evaluate the outcomes of different surgery timings. Methods: We searched multiple databases for studies involving adult patients suffering from symptomatic MSCC who underwent decompression with or without fixation. We analyzed the data by stratifying them based on timing as emergent (≤24 h vs. >24 h) and urgent (≤48 h vs. >48 h). The analysis also considered adverse postoperative medical and surgical events. The rates of improved outcomes and adverse events were pooled through a random-effects meta-analysis. Results: We analyzed seven studies involving 538 patients and discovered that 83.0% (95% CI 59.0–98.2%) of those who underwent urgent decompression showed an improvement of ≥1 point in strength scores. Adverse events were reported in 21% (95% CI 1.8–51.4%) of cases. Patients who underwent emergent surgery had a 41.3% (95% CI 20.4–63.3%) improvement rate but a complication rate of 25.5% (95% CI 15.9–36.3%). Patients who underwent surgery after 48 h showed 36.8% (95% CI 12.2–65.4%) and 28.6% (95% CI 19.5–38.8%) complication rates, respectively. Conclusion: Our study highlights that a 48 h window may be the safest and most beneficial for patients presenting with acute MSCC and a life expectancy of over three months. Full article

(This article belongs to the Special Issue Update and Overview in Spine Metastases Treatment)

► Show Figures