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This study evaluated a novel surgical strategy, separation surgery combined with vertebroplasty and \u00b9\u00b2\u2075I seeds implantation (SSVPI), in this cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seventy-eight patients with lung adenocarcinoma and thoracic vertebral metastases underwent SSVPI. VAS and KPS were assessed preoperatively and at 1 week, 1, 3, 6, and 12 months postoperatively using repeated measures ANOVA. ASIA and ECOG scores were compared before and 3 months after surgery by the Wilcoxon test. OS, PFS, and LPFS were estimated by the Kaplan-Meier method, and Cox regression identified prognostic factors for LPFS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant postoperative improvements in pain and functional status were observed (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). VAS improved from 7.83\u2009\u00b1\u20091.34 preoperatively to 1.86\u2009\u00b1\u20091.48 at 1 week and 2.79\u2009\u00b1\u20091.24 at 12 months; KPS from 41.41\u2009\u00b1\u20099.14 to 74.87\u2009\u00b1\u200915.79 and 71.54\u2009\u00b1\u200914.48. ASIA and ECOG improvement rates were 91.0% and 94.9%, respectively. Detected mutations included EGFR (48.7%), ALK (15.4%), RET (6.4%), and ROS1 (7.7%). Median OS was 33.5 months, median PFS 16.8 months, and median LPFS was not reached. Complication rate was 19.2% (13 cement leaks, 2 seed migrations).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SSVPI is an integrated strategy coupling spinal cord decompression with interstitial \u00b9\u00b2\u2075I brachytherapy and vertebroplasty, thus providing minimally invasive decompression, immediate analgesia, local tumor control, and partial spinal stabilization for patients with lung adenocarcinoma and thoracic metastatic epidural spinal cord compression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00586-026-10116-x","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T01:14:56Z","timestamp":1783041296000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A novel strategy of \u201cSeparation Surgery Combined with Vertebroplasty and Interstitial Implantation of 125I Seeds (SSVPI)\u201d in managing thoracic metastases from lung adenocarcinoma with spinal cord compression"],"prefix":"10.1007","author":[{"given":"Yihao","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohui","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhou","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongqi","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zia-ul-Haq","family":"Nabil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihong","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7805-4925","authenticated-orcid":false,"given":"Tiying","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0763-5805","authenticated-orcid":false,"given":"Zuozhang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"10116_CR1","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1007\/s00586-009-1252-x","volume":"19","author":"D Choi","year":"2010","unstructured":"Choi D, Crockard A, Bunger C, Harms J, Kawahara N, Mazel C, Melcher R, Tomita K (2010) Review of metastatic spine tumour classification and indications for surgery: the consensus statement of the Global Spine Tumour Study Group. 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The research plan was approved by the Ethics Committee of Yunnan Cancer Hospital (Approval No.: KYCS2025-231; Approval Date: May 23, 2025). For retrospectively analyzed imaging data, the Ethics Committee exempted the repeated informed consent requirement in some patients, but all data were anonymous and only clinical parameters related to the study were retained, which complies with the exemption clauses of the Declaration of 1964 Helsinki and the Chinese \u201cEthics Review Measures for Biomedical Research Involving Humans\u201d.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Consent for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial number"}}]}}