In the Journals

Posterior occipitocervical fusion seen as effective for suboccipital spinal metastases

Investigators found posterior-only occipitocervical fusion was effective for neck pain relief in patients with suboccipital spinal metastases.

Researchers identified 15 patients with suboccipital metastases who underwent posterior-only instrumented fusion between 1999 and 2014. Investigators analyzed clinical presentation, perioperative complications and postoperative results. VAS was used to assess pain, and investigators used the revised Tokuhashi scoring system and Tomita scoring system to predict prognosis. The Kaplan-Meier curve was used to perform a survival analysis.

The most common presentation was severe neck pain without a neurological deficit. Investigators noted the most common tumors seen were lung, breast, bladder, myeloma, melanoma and renal cell cancer, with all tumors occurring in the axis vertebra. The preoperative Tokuhashi score ranged from 5 points to 13 points and the preoperative Tomita score ranged from 3 points to 7 points. At a mean of 4.6 levels, all patients underwent occipitocervical fusion.

According to the Kaplan-Meier analysis, the median survival was 10.3 months. Neck pain decreased in all cases and all patients returned to activities of daily living. Compared with the average preoperative score, the average postoperative pain score showed significant improvement. There were five postoperative medical complications that included urinary tract infection, supraventricular tachycardia, atrial fibrillation, deep vein thrombosis and myocardial infarction. – by Monica Jaramillo

Disclosures: Luksanapruksa reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.




 

Investigators found posterior-only occipitocervical fusion was effective for neck pain relief in patients with suboccipital spinal metastases.

Researchers identified 15 patients with suboccipital metastases who underwent posterior-only instrumented fusion between 1999 and 2014. Investigators analyzed clinical presentation, perioperative complications and postoperative results. VAS was used to assess pain, and investigators used the revised Tokuhashi scoring system and Tomita scoring system to predict prognosis. The Kaplan-Meier curve was used to perform a survival analysis.

The most common presentation was severe neck pain without a neurological deficit. Investigators noted the most common tumors seen were lung, breast, bladder, myeloma, melanoma and renal cell cancer, with all tumors occurring in the axis vertebra. The preoperative Tokuhashi score ranged from 5 points to 13 points and the preoperative Tomita score ranged from 3 points to 7 points. At a mean of 4.6 levels, all patients underwent occipitocervical fusion.

According to the Kaplan-Meier analysis, the median survival was 10.3 months. Neck pain decreased in all cases and all patients returned to activities of daily living. Compared with the average preoperative score, the average postoperative pain score showed significant improvement. There were five postoperative medical complications that included urinary tract infection, supraventricular tachycardia, atrial fibrillation, deep vein thrombosis and myocardial infarction. – by Monica Jaramillo

Disclosures: Luksanapruksa reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.