Analysis Of Related Early Complication Factors Of Spinal Metastatic Tumor

Background and PurposeClinical treatment of malignant solid tumors has been updated in recent years,the level of treatment has been continuously improved,the survival time of some tumor patients has been significantly prolonged,and the incidence of spinal metastases has increased.Spine is the most common site of malignant tumor metastasis,and about 30%-70%of tumor patients can find spinal metastases.With the increase of the number of patients with spinal metastatic carcinoma,the treatment methods are constantly updated and improved.At first,laminectomy with decompression and local radiotherapy were considered feasible,and later studies suggested that radiotherapy alone might be more effective.The compression of spinal canal is usually caused by metastatic tumor to destroy spinal bone,causing bone and surrounding soft tissue to compress spinal cord,at the same time,there may be instability of spinal mechanics,only lamin decompression can not touch the main lesions of spinal metastases.Other studies have reported that laminectomy and local radiotherapy have the same effect Some scholars have suggested that surgical techniques should not be used to continue treatment after local radiotherapy has failed.With the progress of science and technology and the continuous updating of surgical methods,the choice of diagnosis and treatment scheme for patients with spinal metastases is now preferred to surgery,while the constantly updated and advanced surgical techniques and auxiliary instruments are more likely to achieve complete spinal decompression and stable spinal fixation.the occurrence of postoperative complications of spinal metastases can affect the postoperative quality of life of patients and may increase the cost of life.the incidence of postoperative complications reported in the article is as high as 39%.therefore,understanding which perioperative variables can predict complications 30 days after surgery will help to assess the risk of patients,guide treatment decisions and improve preoperative informed consent,and to some extent provide clinical data support for the subsequent development of a new prognostic evaluation system for spinal metastases.more and more patients with spinal metastases need to receive surgical treatment,and there are still few domestic and foreign studies on the factors related to their early postoperative complications.this study aims to explore the relevant factors and clinical strategies of early postoperative complications of spinal metastases.MethodsA retrospective analysis of 101 patients with spinal metastases who underwent surgical treatment in the second ward of bone and soft tissue oncology department of the affiliated cancer hospital of zhengzhou university from july 2016 to july 2019.all the candidates were confirmed by preoperative pathological puncture examination and/or postoperative pathological examination of solid malignant tumors with spinal metastasis.All cases were individually developed after the combination of primary tumor condition,physical condition,spinal metastasis and economic condition of the patients.The total was divided into percutaneous vertebroplasty and open surgery.the general demographic characteristics,physical condition,results of hematological examination,primary tumor and.vertebral body metastasis,intraoperative risk factors,early postoperative complications and corresponding clinical strategies were counted to calculate the overall incidence of early postoperative complications and the incidence of each complication.statistical method:statistical data analysis was performed using computer software SPSS(25.0 chinese version,IBM company,amon,new york).because the statistical data did not conform to the normal distribution and the variance was not uniform,the statistical analysis was tested by nonparametric Kruskal-Wallis H(k).the p results<0.05 were considered statistically significant.Results1 The age,BMI,low protein,operative time,operative bleeding volume,operative incision length were the relevant factors affecting the occurrence of early postoperative complications(p<0.05),while the sex,primary tumor type,spinal metastasis location,spinal metastasis number,preoperative anemia,Carcinol score were not the relevant factors affecting the occurrence of early postoperative complications(p>0.05).2 Preoperative low protein,operative time,postoperative bleeding and surgical incision length were the relevant factors affecting the occurrence of cerebrospinal fluid leakage(p<0.05).3 Operative time was the relevant factor affecting the occurrence of pulmonary infection(p p<pp<0.031).4 Age was the relevant factor affecting postoperative delirium(p p<pp<0.017).5 Preoperative low protein,operative time,surgical bleeding volume and surgical incision lengtth were the relevant factors affecting the occurrence of postoperative anemia(p<0.05).6 Postoperative incision infection was the most important postoperative postopeTative complication.Conclusionage,BMI,low protein,operation time,surgical bleeding volume,and surgical incision length are the relevant factors affecting the early postoperative complications of spinal metastases.clinicians should fully consider the influence of these factors on the treatment of patients before the operation plan,and then improve the prognosis and quality of life of patients.