Complications after Surgical Treatment of Spinal Metastases

Background: Metastases predominate among spinal tumors. The choice of the best treatment is always done on a case-by-case basis and is multi-faceted. Surgical treatment is increasingly being used and is often com-bined with postoperative radiotherapy. However, it is fraught with the risk of complications. Awareness of these risks and an ability to reduce their incidence is the key to obtaining good results. The aim of the study was to retrospectively assess complications in patients treated for spinal tumors in our Department of Orthopedic Oncology at the Hospital in Brzozów.

Material and methods: Out of the 846 patients treated for spinal tumors in the years 2011-2016, 723 (85%) were operated on. The results of imaging and biochemical tests, documentation on the course of treatment, surgical protocols as well as patient records from the outpatient clinic were assessed.

Results: In our series, complications occurred in 14% of the patients. They were divided into general-medical (2.7%), orthopedic and neurological (wound healing problems, dural injury, paresis) (11%), and mechanical (0.3%). Complications occurred most often after surgery using a posterior approach in the thoracic spine. In wound healing problems, good results were obtained after surgical treatment of wounds. Damage to the dura mater was repaired du-ring the original operation and cerebrospinal fluid leaks usually resolved spontaneously. Destabilized hardware was replaced during revision procedures.

Conclusions: 1. The rate of complications in the present study was comparable to figures reported in the lite-rature. 2. Radiation therapy had a significant impact on the risk of wound healing complications. The most important risk factor is patients' overall health status, age, previous radiotherapy and steroid therapy, and the presence of neu-rological deficits. 3. Mechanical complications occur mainly in the junctional segments of the spine. 4. Operative treat-ment of wound healing complications produces good results."