Short-term efficacy of separation surgery combined with radiofrequency ablation and bone cement reinforcement for thoracolumbar metastatic tumors

English Keywords:Spinal metastasis tumor  Thoracolumbar  Seperation surgery  Radiofrequency ablation  Bone cement reinforcement  Efficacy

English Abstract:

  【Abstract】 Objectives: To explore the short-term clinical effectiveness of separation surgery combined with radiofrequency ablation and bone cement reinforcement in the comprehensive treatment of metastatic tumors in thoracolumbar spine. Methods: A retrospective analysis was conducted on the clinical data of 93 patients with thoracolumbar metastatic tumors who were admitted to Ningxia Medical University General Hospital from January 2018 to June 2023. Based on different treatment methods, patients were divided into group A(32 patients, 13 males, 19 females, aged 59.8±10.0 years old, treated with separation surgery combined with radiofrequency ablation and bone cement reinforcement), group B(28 patients, 16 males, 12 females, aged 60.5±70.7 years old, treated with separation surgery combined with bone cement reinforcement), and group C(33 patients, 12 males, 21 females, aged 57.5±14.5 years old, treated with radiotherapy ablation). All the patients were assessed using the Eastern Cooperative Oncology Group(ECOG) score, modified Tokuhashi score, Tomita score, spinal instability neoplastic score(SINS), and epidural spinal compression(ESCC) score. The operative time and intraoperative blood loss were compared between the groups, while the Frankel classification, visual analogue scale(VAS) score, and Karnofsky performance status(KPS) score were assessed before treatment and at 1 week, 1 month, and 3 months after treatment for clinical efficacy analysis. Results: All the patients were followed up for 16.1±5.1(6-27 months). 14 patients died during the follow-up period, with a mean survival time of 14.1±4.6 months(7-24 months). There was no statistically significant difference in operative time between groups A and B(P>0.05), but intraoperative blood loss in group A was significantly lower than in group B(P<0.05). There was no significant difference in baseline VAS scores among the three groups(P>0.05). VAS scores in groups A and B were significantly reduced at 1 week, 1 month, and 3 months after treatment, with significant differences compared to group C(P<0.01). In group C, no significant difference was found in VAS scores pre- and post-treatment(P>0.05). Neurological functions showed varying degrees of recovery across all groups. At 1 month after surgery and final follow-up, there was no significant difference in neurological function between groups A and B(P>0.05), but both groups demonstrated significant differences in neurological recovery compared to group C(P<0.05). KPS scores showed no significant difference among the three groups before treatment(P>0.05). However, KPS scores in groups A and B increased significantly at 1 week, 3 months, and final follow-up after treatment, with group A showing a more pronounced improvement compared to group B(P<0.05). Conclusions: Separation surgery combined with radiofrequency ablation and bone cement reinforcement can significantly alleviate pain, improve neurological recovery, enhance functional ability, and markedly improve quality of life in patients with thoracolumbar metastatic tumors.