| Objective Metastasis is one of the main causes for the poor prognosis and high mortality of malignant tumors,and the diagnosis and treatment of metastasis is the focus in the related studies.The most common sites for spinal metastasis are thoracic spine(60%),lumbar spine(25%),cervical spine(15%).In this study,the clinical data from 2005 to 2018 for the patients with thoracolumbar metastasis and underwent posterior decompression and internal fixation operation were retrospectively analyzed to evaluate the factors associated with the mobility and prognosis.Methods A total of 36 patients were in accordance with the inclusion criteria.Neurological deficit was evaluated by Frankel Grade,performance status was evaluated by ECOG score,pain levels was assessed by visual analog scale(VAS),and survival period was predicted by Tokuhashi score.Gender,age,primary tumor type,visceral metastasis,preoperative ECOG score,preoperative walking ability,metastasis period,and postoperative radiotherapy were analyzed by univariate and multivariate analysis for the prognosis.Prognostic survival time predicted by Tokuhashi score and the actual survival time were also compared.Results Postoperative VAS score,ECOG score and Frankel score were statistically improved(p < 0.05).Twelve patients regained the ability to walk after the surgery.Univariate and multivariate analysis indicated that age,primary tumor type,visceral metastasis and postoperative radiotherapy were independent prognostic factors for survival with a statistically significance.Conclusion Posterior decompression and internal fixation operation is a safe and effective way for the treatment of the thoracolumbar metastasis,to ameliorate the pain,maintain or restore the mobility,and improve the life quality.Age,primary tumor type,visceral metastasis,and postoperative radiotherapy are the independent prognostic factors for the survival of patients. |
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