{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:59:19Z","timestamp":1790747959295,"version":"4.1.0"},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>The incidence of suboccipital spinal metastases is rare but has increased given cancer patients' longer life expectancies. Operative treatment in this region is often challenging because of limited fixation points due to tumor lysis, as well as adjacent neural and vascular anatomy. Few studies have reported on this population of cancer patients. The purpose of this study was to evaluate clinical outcomes and complications of patients with suboccipital spinal metastases who had undergone posterior occipitocervical fixation.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A single-institution database was reviewed to identify patients with suboccipital metastases who had undergone posterior-only instrumented fusion between 1999 and 2014. Clinical presentation, perioperative complications, and postoperative results were analyzed. Pain was assessed using the visual analog scale. Survival analysis was performed using a Kaplan-Meier curve. The revised Tokuhashi and the Tomita scoring systems were used for prognosis prediction.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Fifteen patients were identified, 10 men and 5 women with mean age of 64.8 \u00b1 11.8 years (range 48\u201380 years). Severe neck pain without neurological deficit was the most common presentation. Primary tumors included lung, breast, bladder, myeloma, melanoma, and renal cell cancers. All tumors occurred in the axis vertebra. Preoperative Tokuhashi and Tomita scores ranged from 5 to 13 and 3 to 7, respectively. All patients had undergone occipitocervical fusion of a mean of 4.6 levels (range 2\u20137 levels). Median survival was 10.3 months. In all cases, neck pain markedly improved and patients were able to resume activities of daily living. The average postoperative pain score was significantly improved as compared with the average preoperative score (1.90 \u00b1 2.56 and 5.50 \u00b1 2.99, respectively, p = 0.01). Three patients experienced postoperative medical complications including urinary tract infection, deep vein thrombosis, myocardial infarction, and cardiac arrhythmia. In the follow-up period, no wound infections or reoperations occurred and no patients experienced spinal cord deficits from tumor recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Posterior-only occipitocervical stabilization was highly effective at relieving patients' neck pain. No instrumentation failures were noted, and no neurological complications or tumor progression causing spinal cord deficits was noted in the follow-up period.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.10.spine16392","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T15:02:27Z","timestamp":1487948547000},"page":"554-559","source":"Crossref","is-referenced-by-count":15,"title":["Outcomes and effectiveness of posterior occipitocervical fusion for suboccipital spinal metastases"],"prefix":"10.3171","volume":"26","author":[{"given":"Panya","family":"Luksanapruksa","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob M.","family":"Buchowski","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neill M.","family":"Wright","sequence":"additional","affiliation":[{"name":"Neurosurgery, Washington University in St. Louis, Missouri; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank H.","family":"Valone","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen","family":"Peters","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B.","family":"Bumpass","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1097\/00007632-199308000-00006","article-title":"Metastatic lesions of the cervical spine. 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