Neurological recovery after posterior decompression surgery for anterior dural compression in paralytic spinal metastasis

Archives of Orthopaedic and Trauma Surgery
So KatoKiyofumi Yamakawa

Abstract

Paralysis in spinal metastasis is often caused by anterior dural compression, and anterior approach has been frequently chosen for decompression despite its dreadful complications. On the other hand, the effectiveness of posterior indirect decompression has not specifically established. The objective of the present study was to investigate the anatomical patterns of dural compression, and to clarify the effectiveness of posterior surgery for anterior lesions. We retrospectively analyzed the anatomical patterns of spinal metastasis on MRI images and the neurological recovery in the paralytic patients who underwent posterior decompression and fusion surgery with intraoperative radiation therapy. The recovery rate was compared between those with an anterior or circumferential dural compression (A+), who were indirectly decompressed, and those with a posterior and/or lateral dural compression (A-), who were directly decompressed. A total of 135 cases were included in the study, and 81.5% had anterior dural compression (A+). In the A+ group, 88.2% of preoperatively non-ambulatory cases regained the gait. Full recovery was achieved in 50% of preoperatively ambulatory cases. These rates were not significantly different from those in t...Continue Reading

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Citations

Nov 4, 2016·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Keng ChenHuiyong Shen
Oct 24, 2019·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Alexander SpiessbergerSamuel K Cho
Sep 11, 2020·World Journal of Orthopedics·Jessica Ehne, Panagiotis Tsagozis
Jul 22, 2021·The Journal of Bone and Joint Surgery. American Volume·Andrew J SchoenfeldElena Losina

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