{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:20:09Z","timestamp":1789842009007,"version":"4.0.1"},"reference-count":90,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The aim of this study was to systematically review the literature on reported outcomes following decompression surgery for spinal metastases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors conducted MEDLINE, Scopus, and Web of Science database searches for studies reporting clinical outcomes and complications associated with decompression surgery for metastatic spinal tumors. Both retrospective and prospective studies were included. After meeting inclusion criteria, articles were categorized based on the following reported outcomes: survival, ambulation, surgical technique, neurological function, primary tumor histology, and miscellaneous outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of the 4148 articles retrieved from databases, 36 met inclusion criteria. Of those included, 8 were prospective studies and 28 were retrospective studies. The year of publication ranged from 1992 to 2015. Study size ranged from 21 to 711 patients. Three studies found that good preoperative Karnofsky Performance Status (KPS \u2265 80%) was a significant predictor of survival. No study reported a significant effect of time-to-surgery following the onset of spinal cord compression symptoms on survival. Three studies reported improvement in neurological function following surgery. The most commonly cited complication was wound infection or dehiscence (22 studies). Eight studies reported that preoperative ambulatory or preoperative motor status was a significant predictor of postoperative ambulatory status. A wide variety of surgical techniques were reported: posterior decompression and stabilization, posterior decompression without stabilization, and posterior decompression with total or subtotal tumor resection. Although a wide range of functional scales were used to assess neurological outcomes, four studies used the American Spinal Injury Association (ASIA) Impairment Scale to assess neurological function. Four studies reported the effects of radiation therapy and local disease control for spinal metastases. Two studies reported that the type of treatment was not significantly associated with the rate of local control. The most commonly reported primary tumor types included lung cancer, prostate cancer, breast cancer, renal cancer, and gastrointestinal cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>This study reports a systematic review of the literature on decompression surgery for spinal metastases. The results of this study can help educate surgeons on the previously published predictors of outcomes following decompression surgery for metastatic spinal disease. However, the authors also identify significant gaps in the literature and the need for future studies investigating the optimal practice with regard to decompression surgery for spinal metastases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2016.6.focus16166","type":"journal-article","created":{"date-parts":[[2016,8,1]],"date-time":"2016-08-01T03:37:36Z","timestamp":1470022656000},"page":"E2","source":"Crossref","is-referenced-by-count":91,"title":["Decompression surgery for spinal metastases: a systematic review"],"prefix":"10.3171","volume":"41","author":[{"given":"Dara","family":"Bakar","sequence":"first","affiliation":[{"name":"The Warren Alpert Medical School of Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph E.","family":"Tanenbaum","sequence":"additional","affiliation":[{"name":"Center for Spine Health, and\u00a0"},{"name":"Case Western Reserve University School of Medicine;"},{"name":"Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Phan","sequence":"additional","affiliation":[{"name":"NeuroSpine Surgery Research Group, Prince of Wales Private Hospital, Sydney, Australia; and"},{"name":"University of New South Wales, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent J.","family":"Alentado","sequence":"additional","affiliation":[{"name":"Center for Spine Health, and\u00a0"},{"name":"Case Western Reserve University School of Medicine;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Steinmetz","sequence":"additional","affiliation":[{"name":"Center for Spine Health, and\u00a0"},{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward C.","family":"Benzel","sequence":"additional","affiliation":[{"name":"Center for Spine Health, and\u00a0"},{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas E.","family":"Mroz","sequence":"additional","affiliation":[{"name":"Center for Spine Health, and\u00a0"},{"name":"Departments of Neurosurgery and"},{"name":"Orthopaedic Surgery, Cleveland Clinic;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus16166","series-title":"Spinal Cord","first-page":"595","article-title":"Posterior decompression and stabilization for metastatic compression of the thoracic spinal cord: is this procedure still state of the art?","volume":"46","author":"Abel","year":"2008"},{"key":"b2-focus16166","series-title":"Spine J","first-page":"2038","article-title":"Surgery on spinal epidural metastases (SEM) in renal cell carcinoma: a plea for a new paradigm","volume":"14","author":"Bakker","year":"2014"},{"key":"b3-focus16166","series-title":"J Neurosurg Spine","first-page":"56","article-title":"Outcome following decompressive surgery for different histological types of metastatic tumors causing epidural spinal cord compression. 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A matched pair analysis","volume":"41","author":"Lei","year":"2015"},{"key":"b21-focus16166","series-title":"Eur Spine J","article-title":"A validated preoperative score predicting survival and functional outcome in lung cancer patients operated with posterior decompression and stabilization for metastatic spinal cord compression.","author":"Lei","year":"2015"},{"key":"b22-focus16166","series-title":"Ann R Coll Surg Engl","first-page":"28","article-title":"Accuracy of prognostic scores in decision making and predicting outcomes in metastatic spine disease","volume":"94","author":"Majeed","year":"2012"},{"key":"b23-focus16166","series-title":"J Neurosurg Spine","first-page":"518","article-title":"Comparison of minimally invasive surgery with standard open surgery for vertebral thoracic metastases causing acute myelopathy in patients with short- or mid-term life expectancy: surgical technique and early clinical 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G\u00f3mez","year":"1995"},{"key":"b28-focus16166","series-title":"Indian J Orthop","first-page":"307","article-title":"Predictors of survival in surgically treated patients of spinal metastasis","volume":"45","author":"Padalkar","year":"2011"},{"key":"b29-focus16166","series-title":"Spine (Phila Pa 1976)","first-page":"E798","article-title":"Pre- and postoperative lower extremity motor power and ambulatory status of patients with spinal cord compression due to a metastatic spinal tumor","volume":"38","author":"Park","year":"2013"},{"key":"b30-focus16166","series-title":"J Korean Neurosurg Soc","first-page":"434","article-title":"Efficacy of decompression and fixation for metastatic spinal cord compression: analysis of factors prognostic for survival and postoperative ambulation","volume":"50","author":"Park","year":"2011"},{"key":"b31-focus16166","series-title":"Spine J","first-page":"322","article-title":"Surgical results of metastatic spinal cord compression (MSCC) from non-small cell lung cancer (NSCLC): analysis of functional outcome, survival time, and complication","volume":"16","author":"Park","year":"2016"},{"key":"b32-focus16166","series-title":"Lancet","first-page":"643","article-title":"Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial","volume":"366","author":"Patchell","year":"2005"},{"key":"b33-focus16166","series-title":"Oncology","first-page":"177","article-title":"Preoperative scoring and limits of prognostication: functional outcome after surgical decompression in metastatic spinal cord compression","volume":"86","author":"Putz","year":"2014"},{"key":"b34-focus16166","series-title":"Spine J","first-page":"1738","article-title":"The surgical management of metastatic spinal tumors based on an epidural spinal cord compression (ESCC) scale","volume":"15","author":"Quraishi","year":"2015"},{"issue":"Suppl 1","key":"b35-focus16166","series-title":"Eur Spine 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