Title - Evaluation of post-operative outcome of surgically treated patients with spine metastasis Investigator - Dr Pramod S. Chinder Department – Musculoskeltal Oncology

Introduction Surgical treatment, based on decompression of the spinal cord together with restoration of spinal stability, may reduce pain and reestablish function in cancer patients with spinal metastases.

If there is a major neurological deficit, disabling chronic pain or spinal instability, only surgery will reliably and quickly restore function and quality of life.

Research Hypothesis Surgical decompression and stabilization of symptomatic vertebral body metastasis improves the clinical outcome of the patient, irrespective of the survival outcome

Rationale for the study Problem area: In spite of numerous scoring systems, criteria's, clinical trials and guidelines, lack of standardization/protocol Reason/need for study: To investigate the surgical decisions and outcomes of decompression and stabilization for metastatic involvement of vertebral body, so as to provide more references for the clinical treatment of this special and complex condition

Aim To evaluate the outcome of surgical decompression and stabilization, in patients with symptomatic vertebral body metastasis

Objectives To evaluate survival To assess functional outcome To assess change in quality of life Factors favoring better clinical outcome

Literature review “This study shows that important improvement of function can be gained by surgical treatment….”

Materials and Methods Inclusion criteria: Radiological or histological evidence of vertebral metastasis from a histologically proven primary tumour Neurological deficit / disabling pain / Instability (SIN score) Life expectancy >3months No active foci of local or systemic infection Fit for anesthesia & surgery

Methodology All patients evaluated clinic-radiologically Pre op VAS score, Frankel grading and Karnofsky performance scoring MRI for level of involvement, site of cord/nerve root compression, levels to be fixed and/or instrumented Histological conformation when radiological diagnosis is uncertain

Type of study: Analytical observational study- retrospective and prospective Sample size: 96 Precision:5% CI: 95% Statistics: Paired-t test- VAS scores & Karnofsky scores. Postoperative survival will be estimated by Kaplan-Meier analysis.

Parameters

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