A retrospective study about the outcome of spinal metastasis surgery for the patients aged 80 years or older compared to those aged younger than 70 years — The International Society for the Study of the Lumbar Spine
  1. Schedule
  2. GENERAL POSTER SESSION
  3. A retrospective study about the outcome of spinal metastasis surgery for the patients aged 80 years or older compared to those aged younger than 70 years

A retrospective study about the outcome of spinal metastasis surgery for the patients aged 80 years or older compared to those aged younger than 70 years (#1148)

Tomoya Matsuo 1 , Zhongying Zhang 2 , Yutaro Kanda 1 , Takashi Yurube 1 , Yuji Kakiuchi 1 , Yoshiki Takeoka 1 , Ryu Tsujimoto 1 , Kunihiko Miyazaki 1 , Hiroki Ohnishi 1 , Masao Ryu 1 , Ryosuke Kuroda 1 , Kenichiro Kakutani 2
  1. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
  2. Division of Spine Surgery, Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

INTRODUCTION: We have reported that spinal metastasis surgery for the patients aged 70 years or older had as good outcome as that for the patients aged younger than 70 years. However, the number of aged spinal metastasis patients is rapidly increasing in Japan, the most super-aged society in the world. The aim of current study was to retrospectively investigate the outcome of spinal metastasis surgery for the patients aged 80 years or older compared to those aged younger than 70 years.

METHODS: Of one hundred eighty-one patients who had palliative spinal metastasis surgeries from 2013 to 2020, 24 patients aged 80 years or older (mean 83.9 years) (E-group) and 79 patients aged younger than 70 years (mean 56.3 years) (Y-group) were included in current study. Performance Status (PS), Barthel index (BI), EuroQol-5 dimension (EQ-5D) score, and pain (Numerical Rating Scale: NRS) were assessed at pre-operation, one, three and six months after surgery. 

RESULTS: Gender, Katagiri New score, malignancy of the primary lesion of tumor based on Katagiri New Score, operation time, blood loss during the operation and the number of fixed vertebrae did not show significant difference between the groups. The median survival time of E-group and Y-group did not show significant difference (3.7 and 6.2 months, respectively). E-group had significantly worse preoperative PS, BI and EQ-5D score than Y-group (p<0.05). E-group also showed a trend to have higher preoperative NRS than Y-group (p=0.0536). The change of median PS, average BI, EQ-5D score, and NRS of E-group and Y-group at pre-operation, one, three and six months after surgery were 4→3→3→3 and 3→2→1→1 (PS), 45.3→63.2→68.5→92.0 and 63.5→80.7→90.2→97.5 (BI), -0.266→0.275→0.552→0.422 and 0.009→0.535→0.737→0.762 (EQ-5D score), 8.2→3.8→3.9→4.3 and 7.2→3.8→3.4→2.9 (NRS), respectively. Although both groups showed significant improvement of all indexes even six months after surgery compared to those at pre-operation, E-group showed some deterioration of EQ-5D score and pain at that point.

DISCUSSION: Although the current study indicated that spinal metastasis surgery for the patients aged 80 years or older showed less good outcome compared to that for the patients aged younger than 70 years, palliative spinal metastasis surgery for the patients aged 80 years or older, who have less reserve capacity of the body with some more risks of deterioration of general condition, would be an effective option to achieve the improvement of PS, activities of daily living, and quality of life as well as pain relief. Further studies are needed to create the optimal medical care system of spinal metastasis.

#ISSLS2022