Abstract
Introduction
The evolution of conservative treatment, such as radiation therapy, chemotherapy has prolonged significantly life expectancy of patients with spinal tumors. Paradoxically, the complexity of decision making for this patient population increased due to chronic disease management. The purpose of our research is evaluation of health-related quality of life (HRQOL) parameters in patients with spinal tumors and degenerative spinal stenosis.
Material and Methods
Retrospective data were collected for 17 patients with spinal tumors (multiple myeloma (n = 7), metastasis of breast cancer (n = 5), renal cell carcinoma (n = 4), bladder cancer (n = 1)). Inclusion criteria were the following: spinal tumor lesions with 0–6 scores in Spinal Instability Neoplastic Score (SINS), degenerative spinal stenosis with neurological deficit (Frankel grade C-D), unsuccessful nonoperative treatment of degenerative disease (VAS 7–9). According to revised Tokuhashi scoring system, patients were divided into two groups. The first group included 11 patients with 0–8 scores (good prognosis). The second group consisted of 6 patients with 9–11 scores (moderate prognosis). All patients underwent degenerative stenosis surgery using foraminotomy and instrumentalization. Groups were evaluated with HRQOL-scales including VAS, ODI and Frankel. HRQOL-parameters and complications were analyzed and compared between two groups. The comparisons were done by using independent sample Student t-test. A p-value of less than 0.05 was accepted as significant.
Results
HRQOL-scores (VAS, ODI, Frankel) of the patients were increased after operation in both groups. The HRQOL-scores after 18 months are slightly higher in the first group, but we did not get significant difference between groups (p > 0.05). The number of complications in the form of implant instability, proximal and distal junctional disorders was comparable (p > 0.05). No patients had progression of oncology disease or new metastasis of tumor during follow-up in the first group. In the second group tumor came out of remission in 1 case (new visceral and bone metastasis).
Conclusion
Management of spinal degenerative stenosis in patients with spinal tumors provides to increase quality of life. We believe that degenerative stenosis surgery does not affect on progression of oncology disease.