{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:41:45Z","timestamp":1787071305918,"version":"build-2736575974"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"\n Context:<\/jats:title>\n Posterior spinal fixation surgery can improve performance status (PS), alleviate neurological deficits, and reduce pain in patients with metastatic spinal tumors. However, surgical indications and timing vary based on individual patient conditions.<\/jats:p>\n <\/jats:sec>\n \n Aims:<\/jats:title>\n To evaluate postoperative course and improvement in PS following posterior spinal fixation surgery for metastatic spinal tumors.<\/jats:p>\n <\/jats:sec>\n \n Settings and Design:<\/jats:title>\n Single-center and retrospective case-series study.<\/jats:p>\n <\/jats:sec>\n \n Subjects and Methods:<\/jats:title>\n We included 33 patients who underwent posterior spinal fixation surgery for metastatic spinal tumors from April 2017 to April 2024. PS and modified Frankel classification for paralysis were assessed 2 weeks\u2019 postsurgery.<\/jats:p>\n <\/jats:sec>\n \n Statistical Analysis Used:<\/jats:title>\n Fisher\u2019s exact test and Kaplan\u2013Meier survival curves with a log-rank test were used for the analysis.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The cohort included 33 patients (25 men, 8 women; average age, 69 years). Lung cancer was the most common primary tumor (\n n<\/jats:italic>\n = 10). Surgical sites included the cervical (\n n<\/jats:italic>\n = 4), thoracic (\n n<\/jats:italic>\n = 14), thoracolumbar junction (\n n<\/jats:italic>\n = 10), and lumbar\/sacral (\n n<\/jats:italic>\n = 5) regions. The median postoperative survival time was 25 months. Preoperative PS was 0\u20132 in 23 cases and 3\u20134 in 10 cases. Preoperative modified Frankel classification included A (\n n<\/jats:italic>\n = 3), B (\n n<\/jats:italic>\n = 2), C (\n n<\/jats:italic>\n = 3), D (\n n<\/jats:italic>\n = 9), and E (\n n<\/jats:italic>\n = 16). Significant PS improvement was observed in the PS 0\u20132 group compared with that in the PS 3\u20134 group (\n P<\/jats:italic>\n = 0.0209). Paralysis improvement was observed in 3 cases.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Spinal fixation can improve PS in patients with preoperative PS of 0\u20132. Patients with poor initial PS may not experience expected improvements, requiring cautious surgical intervention, and thorough prognostic evaluation.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jcvjs.jcvjs_165_25","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T13:02:11Z","timestamp":1763643731000},"page":"451-457","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Clinical outcomes and performance status improvement after posterior spinal fixation surgery for metastatic spinal tumors: A retrospective case-series study"],"prefix":"10.4103","volume":"16","author":[{"given":"Masato","family":"Yoshimoto","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoya","family":"Matsunobu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiko","family":"Uemori","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiro","family":"Imamura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Maekawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"R1-20260421","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1093\/neuros\/nyaa380","article-title":"Survival trends after surgery for spinal metastatic tumors: 20-year cancer center experience","volume":"88","author":"Rothrock","year":"2021","journal-title":"Neurosurgery"},{"key":"R2-20260421","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1093\/annonc\/mdi122","article-title":"The significance of skeletal-related events for the health-related quality of life of patients with metastatic prostate cancer","volume":"16","author":"Weinfurt","year":"2005","journal-title":"Ann Oncol"},{"key":"R3-20260421","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1302\/2058-5241.2.170006","article-title":"Diagnostic algorithm, prognostic factors and surgical treatment of metastatic cancer diseases of the long bones and spine","volume":"2","author":"Szendr\u0151i","year":"2017","journal-title":"EFORT Open Rev"},{"key":"R4-20260421","doi-asserted-by":"crossref","first-page":"6243s","DOI":"10.1158\/1078-0432.CCR-06-0931","article-title":"Clinical features of metastatic bone disease and risk of skeletal morbidity","volume":"12","author":"Coleman","year":"2006","journal-title":"Clin Cancer Res"},{"key":"R5-20260421","doi-asserted-by":"crossref","first-page":"3000605221091665","DOI":"10.1177\/03000605221091665","article-title":"Spinal metastasis: Narrative reviews of the current evidence and treatment modalities","volume":"50","author":"Jaipanya","year":"2022","journal-title":"J Int Med Res"},{"key":"R6-20260421","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1007\/s00586-004-0870-6","article-title":"Survival, complications and outcome in 282 patients operated for neurological deficit due to thoracic or lumbar spinal metastases","volume":"15","author":"Jansson","year":"2006","journal-title":"Eur Spine J"},{"key":"R8-20260421","first-page":"179","article-title":"The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. 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