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Hoshin Gwak - One of the best experts on this subject based on the ideXlab platform.
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single stage posterior decompression and stabilization for metastasis of the thoracic spine prognostic factors for functional outcome and patients survival
The Spine Journal, 2012Co-Authors: Sangjoon Chong, Sanghoon Shin, Taeahn Jahng, Hoshin GwakAbstract:BACKGROUND CONTEXT: There are limited data analyzing radiological and clinical factors for the functional outcomes of surgery for spinal metastasis. Also, there are few studies to investigate the relationship between the functional outcome and the patients' survival. Thus, analysis of both functional outcomes and the survival with their relationship in a possibly homogenous group of patients is worth being reported. PURPOSE: To assess treatment outcomes of single-stage posterior decompression and stabilization (PDS) with or without corpectomy for thoracic vertebral metastases and to analyze factors affecting both the functional outcome and the patients' survival after the surgical intervention. STUDY DESIGN: Retrospective observational study. PATIENT SAMPLE: A consecutive series of 105 patients, who underwent the previously stated surgery for metastatic spinal cord compression (MSCC) of thoracic spine, were included and retrospectively analyzed. OUTCOME MEASURES: The postoperative functional outcomes were evaluated using visual analog scale and Frankel Grade at postoperative 2 weeks, and all patients were followed for survival analysis. METHODS: An institutional database was searched to identify all patients who underwent single-stage PDS for thoracic metastatic spinal tumors between March 2002 and June 2010. Demographic data as well as preoperative and postoperative medical conditions were collected from medical records. Radiological findings were confirmed on electronic archive. Survival data were obtained either on medical records or with a reference to governmental cancer registry system. RESULTS: Postoperative pain improvement was more evident in patients receiving anterior column reconstruction and four or more levels of fixation (p=.02 and <0.01, respectively). Twenty-one patients (20%) showed improvement of the Frankel Grade, and 10 of 21 Frankel C patients became ambulatory. The preoperative Karnofsky Performance Scale (≥70) and ambulatory status were significant predictors for the postoperative ambulatory function. After surgery, the median overall survival of the patients was 6.0 months. In the univariate analysis, the patient's age (younger than 60 years), type of primary cancer (ie, moderate and slow growth), no visceral metastases, less than three levels of spinal metastases, and postoperative adjuvant therapy were positively significant for the patients' survival (p<.05). In the multivariate analysis, limited (less than three levels) spinal metastases and postoperative adjuvant therapy were proven to significantly prolong the patient's survival (hazard ratios of 0.53 and 0.48, respectively, p<.05). Although the functional outcomes did not directly influence the patients' survival, the patients with better functional outcome showed increased chance of receiving postoperative adjuvant therapy (p<.01). CONCLUSIONS: Single-stage PDS with or without corpectomy effectively improved the functional status of patients with MSCC of the thoracic spine and also afforded the patients to have more chances of postoperative adjuvant therapy, which was significant for patients' survival. Therefore, we suggest that the role of surgery in the management of MSCC could be not only a symptomatic palliation but also a strategy to prolong patients' survival.
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single stage posterior decompression and stabilization for metastasis of the thoracic spine prognostic factors for functional outcome and patients survival
The Spine Journal, 2012Co-Authors: Sangjoon Chong, Sanghoon Shin, Taeahn Jahng, Heon Yoo, Seung Hoon Lee, Kijeong Kim, Hoshin GwakAbstract:Abstract Background context There are limited data analyzing radiological and clinical factors for the functional outcomes of surgery for spinal metastasis. Also, there are few studies to investigate the relationship between the functional outcome and the patients' survival. Thus, analysis of both functional outcomes and the survival with their relationship in a possibly homogenous group of patients is worth being reported. Purpose To assess treatment outcomes of single-stage posterior decompression and stabilization (PDS) with or without corpectomy for thoracic vertebral metastases and to analyze factors affecting both the functional outcome and the patients' survival after the surgical intervention. Study design Retrospective observational study. Patient sample A consecutive series of 105 patients, who underwent the previously stated surgery for metastatic spinal cord compression (MSCC) of thoracic spine, were included and retrospectively analyzed. Outcome measures The postoperative functional outcomes were evaluated using visual analog scale and Frankel Grade at postoperative 2 weeks, and all patients were followed for survival analysis. Methods An institutional database was searched to identify all patients who underwent single-stage PDS for thoracic metastatic spinal tumors between March 2002 and June 2010. Demographic data as well as preoperative and postoperative medical conditions were collected from medical records. Radiological findings were confirmed on electronic archive. Survival data were obtained either on medical records or with a reference to governmental cancer registry system. Results Postoperative pain improvement was more evident in patients receiving anterior column reconstruction and four or more levels of fixation (p=.02 and Conclusions Single-stage PDS with or without corpectomy effectively improved the functional status of patients with MSCC of the thoracic spine and also afforded the patients to have more chances of postoperative adjuvant therapy, which was significant for patients' survival. Therefore, we suggest that the role of surgery in the management of MSCC could be not only a symptomatic palliation but also a strategy to prolong patients' survival.
Sangjoon Chong - One of the best experts on this subject based on the ideXlab platform.
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single stage posterior decompression and stabilization for metastasis of the thoracic spine prognostic factors for functional outcome and patients survival
The Spine Journal, 2012Co-Authors: Sangjoon Chong, Sanghoon Shin, Taeahn Jahng, Hoshin GwakAbstract:BACKGROUND CONTEXT: There are limited data analyzing radiological and clinical factors for the functional outcomes of surgery for spinal metastasis. Also, there are few studies to investigate the relationship between the functional outcome and the patients' survival. Thus, analysis of both functional outcomes and the survival with their relationship in a possibly homogenous group of patients is worth being reported. PURPOSE: To assess treatment outcomes of single-stage posterior decompression and stabilization (PDS) with or without corpectomy for thoracic vertebral metastases and to analyze factors affecting both the functional outcome and the patients' survival after the surgical intervention. STUDY DESIGN: Retrospective observational study. PATIENT SAMPLE: A consecutive series of 105 patients, who underwent the previously stated surgery for metastatic spinal cord compression (MSCC) of thoracic spine, were included and retrospectively analyzed. OUTCOME MEASURES: The postoperative functional outcomes were evaluated using visual analog scale and Frankel Grade at postoperative 2 weeks, and all patients were followed for survival analysis. METHODS: An institutional database was searched to identify all patients who underwent single-stage PDS for thoracic metastatic spinal tumors between March 2002 and June 2010. Demographic data as well as preoperative and postoperative medical conditions were collected from medical records. Radiological findings were confirmed on electronic archive. Survival data were obtained either on medical records or with a reference to governmental cancer registry system. RESULTS: Postoperative pain improvement was more evident in patients receiving anterior column reconstruction and four or more levels of fixation (p=.02 and <0.01, respectively). Twenty-one patients (20%) showed improvement of the Frankel Grade, and 10 of 21 Frankel C patients became ambulatory. The preoperative Karnofsky Performance Scale (≥70) and ambulatory status were significant predictors for the postoperative ambulatory function. After surgery, the median overall survival of the patients was 6.0 months. In the univariate analysis, the patient's age (younger than 60 years), type of primary cancer (ie, moderate and slow growth), no visceral metastases, less than three levels of spinal metastases, and postoperative adjuvant therapy were positively significant for the patients' survival (p<.05). In the multivariate analysis, limited (less than three levels) spinal metastases and postoperative adjuvant therapy were proven to significantly prolong the patient's survival (hazard ratios of 0.53 and 0.48, respectively, p<.05). Although the functional outcomes did not directly influence the patients' survival, the patients with better functional outcome showed increased chance of receiving postoperative adjuvant therapy (p<.01). CONCLUSIONS: Single-stage PDS with or without corpectomy effectively improved the functional status of patients with MSCC of the thoracic spine and also afforded the patients to have more chances of postoperative adjuvant therapy, which was significant for patients' survival. Therefore, we suggest that the role of surgery in the management of MSCC could be not only a symptomatic palliation but also a strategy to prolong patients' survival.
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single stage posterior decompression and stabilization for metastasis of the thoracic spine prognostic factors for functional outcome and patients survival
The Spine Journal, 2012Co-Authors: Sangjoon Chong, Sanghoon Shin, Taeahn Jahng, Heon Yoo, Seung Hoon Lee, Kijeong Kim, Hoshin GwakAbstract:Abstract Background context There are limited data analyzing radiological and clinical factors for the functional outcomes of surgery for spinal metastasis. Also, there are few studies to investigate the relationship between the functional outcome and the patients' survival. Thus, analysis of both functional outcomes and the survival with their relationship in a possibly homogenous group of patients is worth being reported. Purpose To assess treatment outcomes of single-stage posterior decompression and stabilization (PDS) with or without corpectomy for thoracic vertebral metastases and to analyze factors affecting both the functional outcome and the patients' survival after the surgical intervention. Study design Retrospective observational study. Patient sample A consecutive series of 105 patients, who underwent the previously stated surgery for metastatic spinal cord compression (MSCC) of thoracic spine, were included and retrospectively analyzed. Outcome measures The postoperative functional outcomes were evaluated using visual analog scale and Frankel Grade at postoperative 2 weeks, and all patients were followed for survival analysis. Methods An institutional database was searched to identify all patients who underwent single-stage PDS for thoracic metastatic spinal tumors between March 2002 and June 2010. Demographic data as well as preoperative and postoperative medical conditions were collected from medical records. Radiological findings were confirmed on electronic archive. Survival data were obtained either on medical records or with a reference to governmental cancer registry system. Results Postoperative pain improvement was more evident in patients receiving anterior column reconstruction and four or more levels of fixation (p=.02 and Conclusions Single-stage PDS with or without corpectomy effectively improved the functional status of patients with MSCC of the thoracic spine and also afforded the patients to have more chances of postoperative adjuvant therapy, which was significant for patients' survival. Therefore, we suggest that the role of surgery in the management of MSCC could be not only a symptomatic palliation but also a strategy to prolong patients' survival.
Byungjoon Shin - One of the best experts on this subject based on the ideXlab platform.
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safety and efficacy of pedicle screws and titanium mesh cage in the treatments of tuberculous spondylitis of the thoracolumbar spine
Asian Spine Journal, 2008Co-Authors: Jae Chul Lee, Yonil Kim, Byungjoon ShinAbstract:Study Design: This is a retrospective series. Purpose: We wanted to analyze the safety and effectiveness of using the newer generation metallic implants (pedicle screws and/or titanium mesh) for the treatment of tuberculous spondylitis. Overview of the Literature: There have been various efforts to prevent the development of a kyphotic deformity after the treatment of tuberculous spondylitis, including instrumentation of the spine. Pedicle screws and titanium mesh cages have become more and more popular for treating various spinal problems. Methods: Twenty two patients who had tuberculous spondylitis were treated with anterior radical debridement and their anterior column of spine was supported with a tricortical iliac bone graft (12 patients) or by mesh (10 patients). Supplementary posterior pedicle screw instrumentation was performed in 17 of 22 patients. The combination of surgeries were anterior strut bone grafting and posterior pedicle screws in 12 patients, anterior titanium mesh and posterior pedicle screws in 5 patients and anterior mesh only without pedicle screws in 5 patients. The patients were followed up with assessing the laboratory inflammatory parameters, the serial plain radiographs and the neurological recovery. Results: The erythrocyte sedimentation rate and C-reactive protein levels were eventually normalized and there was no case of persistent infection or failure to control infection in spite of a mettalic implant in situ. The overall correction of kyphotic deformity was initially 8.9 degrees, and the loss of correction was 6.2 degrees. In spite of some loss of correction, this technique effectively prevented clinically significant kyphotic deformity. The preoperative Frankel Grades were B for 1 patient, C for 4, D for 4 and E for 13. At the final follow-up, 7 of 9 patients recovered completely to Frankel Grade E and only two patients showed a Frankel Grade of D. Conclusions: Stabilizing the spine with pedicle screws and/or titanium mesh in patients with tubercuous spondylitis effectively prevents the development of kyphotic deformity and this did not prevent controlling infection when this technique was combined with radical debridement and anti-tuberculous chemotherapy.
Taeahn Jahng - One of the best experts on this subject based on the ideXlab platform.
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single stage posterior decompression and stabilization for metastasis of the thoracic spine prognostic factors for functional outcome and patients survival
The Spine Journal, 2012Co-Authors: Sangjoon Chong, Sanghoon Shin, Taeahn Jahng, Hoshin GwakAbstract:BACKGROUND CONTEXT: There are limited data analyzing radiological and clinical factors for the functional outcomes of surgery for spinal metastasis. Also, there are few studies to investigate the relationship between the functional outcome and the patients' survival. Thus, analysis of both functional outcomes and the survival with their relationship in a possibly homogenous group of patients is worth being reported. PURPOSE: To assess treatment outcomes of single-stage posterior decompression and stabilization (PDS) with or without corpectomy for thoracic vertebral metastases and to analyze factors affecting both the functional outcome and the patients' survival after the surgical intervention. STUDY DESIGN: Retrospective observational study. PATIENT SAMPLE: A consecutive series of 105 patients, who underwent the previously stated surgery for metastatic spinal cord compression (MSCC) of thoracic spine, were included and retrospectively analyzed. OUTCOME MEASURES: The postoperative functional outcomes were evaluated using visual analog scale and Frankel Grade at postoperative 2 weeks, and all patients were followed for survival analysis. METHODS: An institutional database was searched to identify all patients who underwent single-stage PDS for thoracic metastatic spinal tumors between March 2002 and June 2010. Demographic data as well as preoperative and postoperative medical conditions were collected from medical records. Radiological findings were confirmed on electronic archive. Survival data were obtained either on medical records or with a reference to governmental cancer registry system. RESULTS: Postoperative pain improvement was more evident in patients receiving anterior column reconstruction and four or more levels of fixation (p=.02 and <0.01, respectively). Twenty-one patients (20%) showed improvement of the Frankel Grade, and 10 of 21 Frankel C patients became ambulatory. The preoperative Karnofsky Performance Scale (≥70) and ambulatory status were significant predictors for the postoperative ambulatory function. After surgery, the median overall survival of the patients was 6.0 months. In the univariate analysis, the patient's age (younger than 60 years), type of primary cancer (ie, moderate and slow growth), no visceral metastases, less than three levels of spinal metastases, and postoperative adjuvant therapy were positively significant for the patients' survival (p<.05). In the multivariate analysis, limited (less than three levels) spinal metastases and postoperative adjuvant therapy were proven to significantly prolong the patient's survival (hazard ratios of 0.53 and 0.48, respectively, p<.05). Although the functional outcomes did not directly influence the patients' survival, the patients with better functional outcome showed increased chance of receiving postoperative adjuvant therapy (p<.01). CONCLUSIONS: Single-stage PDS with or without corpectomy effectively improved the functional status of patients with MSCC of the thoracic spine and also afforded the patients to have more chances of postoperative adjuvant therapy, which was significant for patients' survival. Therefore, we suggest that the role of surgery in the management of MSCC could be not only a symptomatic palliation but also a strategy to prolong patients' survival.
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single stage posterior decompression and stabilization for metastasis of the thoracic spine prognostic factors for functional outcome and patients survival
The Spine Journal, 2012Co-Authors: Sangjoon Chong, Sanghoon Shin, Taeahn Jahng, Heon Yoo, Seung Hoon Lee, Kijeong Kim, Hoshin GwakAbstract:Abstract Background context There are limited data analyzing radiological and clinical factors for the functional outcomes of surgery for spinal metastasis. Also, there are few studies to investigate the relationship between the functional outcome and the patients' survival. Thus, analysis of both functional outcomes and the survival with their relationship in a possibly homogenous group of patients is worth being reported. Purpose To assess treatment outcomes of single-stage posterior decompression and stabilization (PDS) with or without corpectomy for thoracic vertebral metastases and to analyze factors affecting both the functional outcome and the patients' survival after the surgical intervention. Study design Retrospective observational study. Patient sample A consecutive series of 105 patients, who underwent the previously stated surgery for metastatic spinal cord compression (MSCC) of thoracic spine, were included and retrospectively analyzed. Outcome measures The postoperative functional outcomes were evaluated using visual analog scale and Frankel Grade at postoperative 2 weeks, and all patients were followed for survival analysis. Methods An institutional database was searched to identify all patients who underwent single-stage PDS for thoracic metastatic spinal tumors between March 2002 and June 2010. Demographic data as well as preoperative and postoperative medical conditions were collected from medical records. Radiological findings were confirmed on electronic archive. Survival data were obtained either on medical records or with a reference to governmental cancer registry system. Results Postoperative pain improvement was more evident in patients receiving anterior column reconstruction and four or more levels of fixation (p=.02 and Conclusions Single-stage PDS with or without corpectomy effectively improved the functional status of patients with MSCC of the thoracic spine and also afforded the patients to have more chances of postoperative adjuvant therapy, which was significant for patients' survival. Therefore, we suggest that the role of surgery in the management of MSCC could be not only a symptomatic palliation but also a strategy to prolong patients' survival.
Sanghoon Shin - One of the best experts on this subject based on the ideXlab platform.
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single stage posterior decompression and stabilization for metastasis of the thoracic spine prognostic factors for functional outcome and patients survival
The Spine Journal, 2012Co-Authors: Sangjoon Chong, Sanghoon Shin, Taeahn Jahng, Hoshin GwakAbstract:BACKGROUND CONTEXT: There are limited data analyzing radiological and clinical factors for the functional outcomes of surgery for spinal metastasis. Also, there are few studies to investigate the relationship between the functional outcome and the patients' survival. Thus, analysis of both functional outcomes and the survival with their relationship in a possibly homogenous group of patients is worth being reported. PURPOSE: To assess treatment outcomes of single-stage posterior decompression and stabilization (PDS) with or without corpectomy for thoracic vertebral metastases and to analyze factors affecting both the functional outcome and the patients' survival after the surgical intervention. STUDY DESIGN: Retrospective observational study. PATIENT SAMPLE: A consecutive series of 105 patients, who underwent the previously stated surgery for metastatic spinal cord compression (MSCC) of thoracic spine, were included and retrospectively analyzed. OUTCOME MEASURES: The postoperative functional outcomes were evaluated using visual analog scale and Frankel Grade at postoperative 2 weeks, and all patients were followed for survival analysis. METHODS: An institutional database was searched to identify all patients who underwent single-stage PDS for thoracic metastatic spinal tumors between March 2002 and June 2010. Demographic data as well as preoperative and postoperative medical conditions were collected from medical records. Radiological findings were confirmed on electronic archive. Survival data were obtained either on medical records or with a reference to governmental cancer registry system. RESULTS: Postoperative pain improvement was more evident in patients receiving anterior column reconstruction and four or more levels of fixation (p=.02 and <0.01, respectively). Twenty-one patients (20%) showed improvement of the Frankel Grade, and 10 of 21 Frankel C patients became ambulatory. The preoperative Karnofsky Performance Scale (≥70) and ambulatory status were significant predictors for the postoperative ambulatory function. After surgery, the median overall survival of the patients was 6.0 months. In the univariate analysis, the patient's age (younger than 60 years), type of primary cancer (ie, moderate and slow growth), no visceral metastases, less than three levels of spinal metastases, and postoperative adjuvant therapy were positively significant for the patients' survival (p<.05). In the multivariate analysis, limited (less than three levels) spinal metastases and postoperative adjuvant therapy were proven to significantly prolong the patient's survival (hazard ratios of 0.53 and 0.48, respectively, p<.05). Although the functional outcomes did not directly influence the patients' survival, the patients with better functional outcome showed increased chance of receiving postoperative adjuvant therapy (p<.01). CONCLUSIONS: Single-stage PDS with or without corpectomy effectively improved the functional status of patients with MSCC of the thoracic spine and also afforded the patients to have more chances of postoperative adjuvant therapy, which was significant for patients' survival. Therefore, we suggest that the role of surgery in the management of MSCC could be not only a symptomatic palliation but also a strategy to prolong patients' survival.
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single stage posterior decompression and stabilization for metastasis of the thoracic spine prognostic factors for functional outcome and patients survival
The Spine Journal, 2012Co-Authors: Sangjoon Chong, Sanghoon Shin, Taeahn Jahng, Heon Yoo, Seung Hoon Lee, Kijeong Kim, Hoshin GwakAbstract:Abstract Background context There are limited data analyzing radiological and clinical factors for the functional outcomes of surgery for spinal metastasis. Also, there are few studies to investigate the relationship between the functional outcome and the patients' survival. Thus, analysis of both functional outcomes and the survival with their relationship in a possibly homogenous group of patients is worth being reported. Purpose To assess treatment outcomes of single-stage posterior decompression and stabilization (PDS) with or without corpectomy for thoracic vertebral metastases and to analyze factors affecting both the functional outcome and the patients' survival after the surgical intervention. Study design Retrospective observational study. Patient sample A consecutive series of 105 patients, who underwent the previously stated surgery for metastatic spinal cord compression (MSCC) of thoracic spine, were included and retrospectively analyzed. Outcome measures The postoperative functional outcomes were evaluated using visual analog scale and Frankel Grade at postoperative 2 weeks, and all patients were followed for survival analysis. Methods An institutional database was searched to identify all patients who underwent single-stage PDS for thoracic metastatic spinal tumors between March 2002 and June 2010. Demographic data as well as preoperative and postoperative medical conditions were collected from medical records. Radiological findings were confirmed on electronic archive. Survival data were obtained either on medical records or with a reference to governmental cancer registry system. Results Postoperative pain improvement was more evident in patients receiving anterior column reconstruction and four or more levels of fixation (p=.02 and Conclusions Single-stage PDS with or without corpectomy effectively improved the functional status of patients with MSCC of the thoracic spine and also afforded the patients to have more chances of postoperative adjuvant therapy, which was significant for patients' survival. Therefore, we suggest that the role of surgery in the management of MSCC could be not only a symptomatic palliation but also a strategy to prolong patients' survival.
