Circumferential Spinal Cord Decompression And Reconstruction Versus Posterior Decompression Combine Vertebroplasty In The Treatment Of Thoracolumbar Spinal Metastasis

ObjectiveTo investigate the clinical effects of circumferential spinal cord decompression combine titanium mesh implantation versus posterior decompression combine vertebroplasty for the treatment of thoracolumbar spinal metastasis.MethodsWe retrospectively reviewed the follow-up data of thirty eight patients between July 2011 and march 2015.The patients were divided into two groups.15 of the patients underwent circumferential spinal cord decompression combine titanium mesh implantation and 23 of them underwent posterior decompression combine vertebroplasty. We recorded operation time, blood loss, postoperative complications and survival time, estimating pain, quality of life and neurological function by VAS score, SF-36 score and ASIA neurological function classification respectively,and the Kaplan-Meier curve for survival.ResultsThe mean postoperative follow-up was 18 months( 5- 40 months).The mean operation time of circumferential decompression group was 293.26±78.35 min,mean blood loss was 902.67±340.11 ml. The mean operation time of posterior decompression group 181.26±38.78 min,mean blood loss was 552.17±327.69 ml. Both the VAS score of the two groups significantly improved by the time of 1 month and the last follow-up( P < 0. 05). The VAS score of circumferential decompression group was better than that of posterior decompression group(P=0.008),while showing no significant difference the last follow-up(P=0.941). The ASIA of the two groups showed no significant difference(χ2=1.206,P=0.332). Both the SF-36 score of the two groups significantly improved(p<0.05), while the quality of circumferential decompression group was better than that of posterior decompression group(p=0.033). The median survival time of the circumferential decompression group was 16 months and that of the posterior decompression group was 12 months(χ2=1.329,P= 0.454).ConclusionsBoth circumferential spinal cord decompression combine titanium mesh implantation and posterior decompression combine vertebroplasty could achieve satisfied outcome in the treatment of thoracolumbar spinal metastasis, the latter showed less iatrogenic injury.