{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T16:16:23Z","timestamp":1780071383181,"version":"3.54.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Considering the shorter life expectancy and poorer prognosis of metastatic epidural spinal cord compression patients, anterior reconstruction and fusion may be unnecessary. This study aimed to investigate the outcomes of palliative surgery for metastatic epidural spinal cord compression with neurological deficit among patients who underwent posterior decompression and instrumentation without fusion or anterior reconstruction. This single-center retrospective review included all patients aged\u2009&gt;\u200918\u00a0years with thoracic or lumbar spinal metastasis who were surgically treated for metastatic spinal cord compression without fusion or anterior reconstruction at the Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand during July 2015 to December 2017. Data from preoperation to the 1-year follow-up, including demographic and clinical data, Frankel classification, pain scores, complication, revision surgery, health-related quality-of-life scores, and survival data, were collected and analyzed. A total of 30 patients were included. The mean age was 59.83\u2009\u00b1\u200911.73\u00a0years, and 20 (66.7%) patients were female. The mean operative time was 208.17\u2009\u00b1\u200958.41\u00a0min. At least one Frankel grade improvement was reported in 53.33% of patients. The pain visual analog scale, the EuroQOL five-dimension five-level utility score, and the Oswestry Disability Index were all significantly improved at a minimum of 3\u00a0months after surgery. No intraoperative mortality or instrument-related complication was reported. The mean survival duration was 11.4\u2009\u00b1\u20098.97\u00a0months. Palliative non-fusion surgery without anterior reconstruction may be considered as a preferable choice for treating spinal metastasis patients with spinal cord compression with neurological deficits.<\/jats:p>","DOI":"10.1038\/s41598-021-97056-2","type":"journal-article","created":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T10:04:51Z","timestamp":1630490691000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Non-fusion palliative spine surgery without reconstruction is safe and effective in spinal metastasis patients: retrospective study"],"prefix":"10.1038","volume":"11","author":[{"given":"Siravich","family":"Suvithayasiri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Borriwat","family":"Santipas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirichai","family":"Wilartratsami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monchai","family":"Ruangchainikom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panya","family":"Luksanapruksa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,9,1]]},"reference":[{"key":"97056_CR1","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1016\/s0140-6736(05)66954-1","volume":"366","author":"RA Patchell","year":"2005","unstructured":"Patchell, R. A. et al. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: A randomised trial. Lancet (London, England) 366, 643\u2013648. https:\/\/doi.org\/10.1016\/s0140-6736(05)66954-1 (2005).","journal-title":"Lancet (London, England)"},{"key":"97056_CR2","doi-asserted-by":"publisher","first-page":"E11","DOI":"10.3171\/2016.5.focus16129","volume":"41","author":"C Molina","year":"2016","unstructured":"Molina, C. et al. Posterior approaches for symptomatic metastatic spinal cord compression. Neurosurg. Focus 41, E11. https:\/\/doi.org\/10.3171\/2016.5.focus16129 (2016).","journal-title":"Neurosurg. Focus"},{"key":"97056_CR3","doi-asserted-by":"publisher","first-page":"36","DOI":"10.2106\/00004623-198163010-00005","volume":"63","author":"KD Harrington","year":"1981","unstructured":"Harrington, K. D. The use of methylmethacrylate for vertebral-body replacement and anterior stabilization of pathological fracture-dislocations of the spine due to metastatic malignant disease. J. Bone Joint Surg. Am. 63, 36\u201346 (1981).","journal-title":"J. Bone Joint Surg. Am."},{"key":"97056_CR4","doi-asserted-by":"publisher","first-page":"375","DOI":"10.2106\/00004623-198567030-00004","volume":"67","author":"T Siegal","year":"1985","unstructured":"Siegal, T., Tiqva, P. & Siegal, T. Vertebral body resection for epidural compression by malignant tumors. Results of forty-seven consecutive operative procedures. J. Bone Joint Surg. Am. 67, 375\u2013382 (1985).","journal-title":"J. Bone Joint Surg. Am."},{"key":"97056_CR5","doi-asserted-by":"publisher","first-page":"1150","DOI":"10.1097\/00007632-200405150-00019","volume":"29","author":"KT Lewandrowski","year":"2004","unstructured":"Lewandrowski, K. U. et al.  Anterior spinal arthrodesis with structural cortical allografts and instrumentation for spine tumor surgery. Spine 29, 1150\u20131158. https:\/\/doi.org\/10.1097\/00007632-200405150-00019 (2004).","journal-title":"Spine"},{"key":"97056_CR6","doi-asserted-by":"publisher","first-page":"287","DOI":"10.3171\/spi.2004.1.3.0287","volume":"1","author":"JC Wang","year":"2004","unstructured":"Wang, J. C. et al. Single-stage posterolateral transpedicular approach for resection of epidural metastatic spine tumors involving the vertebral body with circumferential reconstruction: Results in 140 patients. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004. J. Neurosurg. Spine 1, 287\u2013298. https:\/\/doi.org\/10.3171\/spi.2004.1.3.0287 (2004).","journal-title":"J. Neurosurg. Spine"},{"key":"97056_CR7","first-page":"459","volume":"71","author":"T Ernstberger","year":"2005","unstructured":"Ernstberger, T., Br\u00fcning, T. & K\u00f6nig, F. Vertebrectomy and anterior reconstruction for the treatment of spinal metastases. Acta Orthop. Belg. 71, 459\u2013466 (2005).","journal-title":"Acta Orthop. Belg."},{"key":"97056_CR8","doi-asserted-by":"publisher","first-page":"27","DOI":"10.3171\/2013.4.spine12344","volume":"19","author":"R Jandial","year":"2013","unstructured":"Jandial, R., Kelly, B. & Chen, M. Y. Posterior-only approach for lumbar vertebral column resection and expandable cage reconstruction for spinal metastases. J. Neurosurg. Spine 19, 27\u201333. https:\/\/doi.org\/10.3171\/2013.4.spine12344 (2013).","journal-title":"J. Neurosurg. Spine"},{"key":"97056_CR9","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1016\/j.wneu.2016.08.007","volume":"95","author":"Y Gezercan","year":"2016","unstructured":"Gezercan, Y. et al. Single-stage posterolateral transpedicular approach with 360-degree stabilization and vertebrectomy in primary and metastatic tumors of the spine. World Neurosurg. 95, 214\u2013221. https:\/\/doi.org\/10.1016\/j.wneu.2016.08.007 (2016).","journal-title":"World Neurosurg."},{"key":"97056_CR10","doi-asserted-by":"publisher","first-page":"42","DOI":"10.3171\/spi.1999.90.1.0042","volume":"90","author":"DW Cahill","year":"1999","unstructured":"Cahill, D. W. & Kumar, R. Palliative subtotal vertebrectomy with anterior and posterior reconstruction via a single posterior approach. J. Neurosurg. 90, 42\u201347. https:\/\/doi.org\/10.3171\/spi.1999.90.1.0042 (1999).","journal-title":"J. Neurosurg."},{"key":"97056_CR11","doi-asserted-by":"publisher","first-page":"E623","DOI":"10.1097\/BRS.0b013e3181573eea","volume":"32","author":"YJ Chen","year":"2007","unstructured":"Chen, Y. J., Hsu, H. C., Chen, K. H., Li, T. C. & Lee, T. S. Transpedicular partial corpectomy without anterior vertebral reconstruction in thoracic spinal metastases. Spine 32, E623-626. https:\/\/doi.org\/10.1097\/BRS.0b013e3181573eea (2007).","journal-title":"Spine"},{"key":"97056_CR12","doi-asserted-by":"publisher","first-page":"653","DOI":"10.3171\/jns.1977.47.5.0653","volume":"47","author":"CA Cobb 3rd","year":"1977","unstructured":"Cobb, C. A. 3rd., Leavens, M. E. & Eckles, N. Indications for nonoperative treatment of spinal cord compression due to breast cancer. J. Neurosurg. 47, 653\u2013658. https:\/\/doi.org\/10.3171\/jns.1977.47.5.0653 (1977).","journal-title":"J. Neurosurg."},{"key":"97056_CR13","doi-asserted-by":"publisher","first-page":"1611","DOI":"10.1016\/s0003-4975(97)01034-5","volume":"64","author":"GL Walsh","year":"1997","unstructured":"Walsh, G. L. et al. Anterior approaches to the thoracic spine in patients with cancer: Indications and results. Ann. Thorac. Surg. 64, 1611\u20131618. https:\/\/doi.org\/10.1016\/s0003-4975(97)01034-5 (1997).","journal-title":"Ann. Thorac. Surg."},{"key":"97056_CR14","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1212\/wnl.9.2.91","volume":"9","author":"KD Barron","year":"1959","unstructured":"Barron, K. D., Hirano, A., Araki, S. & Terry, R. D. Experiences with metastatic neoplasms involving the spinal cord. Neurology 9, 91\u2013106. https:\/\/doi.org\/10.1212\/wnl.9.2.91 (1959).","journal-title":"Neurology"},{"key":"97056_CR15","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1007\/bf01402610","volume":"107","author":"F Bach","year":"1990","unstructured":"Bach, F. et al. Metastatic spinal cord compression. Occurrence, symptoms, clinical presentations and prognosis in 398 patients with spinal cord compression. Acta Neurochir. 107, 37\u201343. https:\/\/doi.org\/10.1007\/bf01402610 (1990).","journal-title":"Acta Neurochir."},{"key":"97056_CR16","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1093\/neuros\/nyx567","volume":"82","author":"O Barzilai","year":"2018","unstructured":"Barzilai, O., Fisher, C. G. & Bilsky, M. H. State of the art treatment of spinal metastatic disease. Neurosurgery 82, 757\u2013769. https:\/\/doi.org\/10.1093\/neuros\/nyx567 (2018).","journal-title":"Neurosurgery"},{"key":"97056_CR17","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1055\/s-0032-1326948","volume":"2","author":"A Matsumura","year":"2012","unstructured":"Matsumura, A., Hoshi, M., Takami, M., Tashiro, T. & Nakamura, H. Radiation therapy without surgery for spinal metastases: Clinical outcome and prognostic factors analysis for pain control. Glob. Spine J. 2, 137\u2013142. https:\/\/doi.org\/10.1055\/s-0032-1326948 (2012).","journal-title":"Glob. Spine J."},{"key":"97056_CR18","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1007\/s11060-015-1990-z","volume":"126","author":"SH Lee","year":"2016","unstructured":"Lee, S. H. et al. Can the spinal instability neoplastic score prior to spinal radiosurgery predict compression fractures following stereotactic spinal radiosurgery for metastatic spinal tumor? A post hoc analysis of prospective phase II single-institution trials. J. Neurooncol. 126, 509\u2013517. https:\/\/doi.org\/10.1007\/s11060-015-1990-z (2016).","journal-title":"J. Neurooncol."},{"key":"97056_CR19","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1634\/theoncologist.2012-0293","volume":"18","author":"I Laufer","year":"2013","unstructured":"Laufer, I. et al. The NOMS framework: Approach to the treatment of spinal metastatic tumors. Oncologist 18, 744\u2013751. https:\/\/doi.org\/10.1634\/theoncologist.2012-0293 (2013).","journal-title":"Oncologist"},{"issue":"Suppl 20","key":"97056_CR20","doi-asserted-by":"publisher","first-page":"S254","DOI":"10.1097\/brs.0000000000001819","volume":"41","author":"F Altaf","year":"2016","unstructured":"Altaf, F. et al. Evidence-based review and survey of expert opinion of reconstruction of metastatic spine tumors. Spine 41(Suppl 20), S254-s261. https:\/\/doi.org\/10.1097\/brs.0000000000001819 (2016).","journal-title":"Spine"},{"key":"97056_CR21","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1055\/s-0030-1267085","volume":"2","author":"JR Wilson","year":"2011","unstructured":"Wilson, J. R., Hashimoto, R. E., Dettori, J. R. & Fehlings, M. G. Spinal cord injury and quality of life: A systematic review of outcome measures. Evidence Based Spine Care J. 2, 37\u201344. https:\/\/doi.org\/10.1055\/s-0030-1267085 (2011).","journal-title":"Evidence Based Spine Care J."},{"key":"97056_CR22","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.1016\/j.spinee.2017.11.020","volume":"18","author":"E Itshayek","year":"2018","unstructured":"Itshayek, E. et al. Ambulation and survival following surgery in elderly patients with metastatic epidural spinal cord compression. Spine J. 18, 1211\u20131221. https:\/\/doi.org\/10.1016\/j.spinee.2017.11.020 (2018).","journal-title":"Spine J."},{"key":"97056_CR23","doi-asserted-by":"publisher","unstructured":"Ju, D. G. et al. Factors associated with improved outcomes following decompressive surgery for prostate cancer metastatic to the spine. Neurosurgery 73, 657\u2013666; discussion 666. https:\/\/doi.org\/10.1227\/neu.0000000000000070 (2013).","DOI":"10.1227\/neu.0000000000000070"},{"key":"97056_CR24","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1186\/s13018-015-0255-z","volume":"10","author":"CC Chang","year":"2015","unstructured":"Chang, C. C. et al. Palliative transpedicular partial corpectomy without anterior vertebral reconstruction in lower thoracic and thoracolumbar junction spinal metastases. J. Orthop. Surg. Res. 10, 113. https:\/\/doi.org\/10.1186\/s13018-015-0255-z (2015).","journal-title":"J. Orthop. Surg. Res."},{"key":"97056_CR25","doi-asserted-by":"publisher","first-page":"337","DOI":"10.3109\/02688697.2015.1133802","volume":"30","author":"D Choi","year":"2016","unstructured":"Choi, D. et al. Rapid improvements in pain and quality of life are sustained after surgery for spinal metastases in a large prospective cohort. Br. J. Neurosurg. 30, 337\u2013344. https:\/\/doi.org\/10.3109\/02688697.2015.1133802 (2016).","journal-title":"Br. J. Neurosurg."},{"key":"97056_CR26","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.1007\/s007010070018","volume":"142","author":"M M\u00fchlbauer","year":"2000","unstructured":"M\u00fchlbauer, M., Pfisterer, W., Eyb, R. & Knosp, E. Noncontiguous spinal metastases, and plasmocytomas should be operated on through a single posterior midline approach, and circumferential decompression should be performed with individualized reconstruction. Acta Neurochir. 142, 1219\u20131230. https:\/\/doi.org\/10.1007\/s007010070018 (2000).","journal-title":"Acta Neurochir."},{"key":"97056_CR27","doi-asserted-by":"publisher","first-page":"1898","DOI":"10.1097\/BRS.0b013e31817c0410","volume":"33","author":"T Kondo","year":"2008","unstructured":"Kondo, T., Hozumi, T., Goto, T., Seichi, A. & Nakamura, K. Intraoperative radiotherapy combined with posterior decompression and stabilization for non-ambulant paralytic patients due to spinal metastasis. Spine 33, 1898\u20131904. https:\/\/doi.org\/10.1097\/BRS.0b013e31817c0410 (2008).","journal-title":"Spine"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-97056-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-97056-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-97056-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T15:22:26Z","timestamp":1670080946000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-97056-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,1]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["97056"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-97056-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,1]]},"assertion":[{"value":"15 May 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 August 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 September 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"17486"}}