32% of spine metastatic disease surgery patients suffered complication at 30 days: 5 observations


A new study published in The Spine Journal examined complications and re-operations for spine metastatic disease patients.

The study included 647 patients who underwent spine surgery for metastatic disease between 2002 and 2014. The researchers investigated complications within 30 days after surgery as well as re-operations until final follow-up.

Here are five observations:

1. Of the patients, 32 percent experienced a complication within 30 days.

2. These variables proved independently associated with 30-day complications:
• Lower albumin levels
• Additional comorbidities
• Pathologic fracture
• Three or more operated spine levels
• Combined surgical approach

3. After the initial surgery, 18 percent of the patients underwent at least one re-operation. The researchers found radiotherapy prior to the spinal tumor to be independently associated with re-operation.

4. Researchers found 30-day complications were associated with worse survival, but re-operation was not.

5. Researchers concluded: "Three or more spine levels operated upon and prior radiotherapy should prompt consideration of a pre-operative plastic surgery consultation regarding soft tissue coverage." Additionally, providers should consider nutritional supplementation for patients with low preoperative serum albumin levels.

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