Early Re-Operation in Patient with Spinal Metastases
Purpose: The objective of this study is to describe the indications
for early (within 30days) reoperations in patients with spinal
metastases to facilitate understanding and post-operative care.
Methods: An “ambispective” cohort of 502 patients based on
Aarhus Spinal Metastases Database. Biodata, indications for
reoperation, timing of reoperation and Tokuhashi score were
documented. Significant Statistical inference was drawn at p<0.05.
Results: Thirty-nine out of 502 patients had reoperation within
30days. Median age was 59yrs. Reoperation rate was 7.8%.
Median survival was 7.2months and 8.1 months for the remaining
cohort. Thirty-six (92.3%) patients underwent single reoperation.
Early deterioration in neurological function was the most common
clinical condition. Reasons for reoperations are; hematoma (38.5%)
was the commonest; others are surgical site infection (15.4%),
vertebral instability (7.7%), recurrent tumor infiltration (7.7%),
persistent radicular pain (5.1%), imminent cord compression (5.1%)
and unknown etiology (15.4%). Sixteen patients had reoperation
within 7 days. Reoperation was most frequent in patients with poor
Conclusion: Hematoma and surgical site infection were the most
common reasons for reoperation, which can be prevented. Regular
clinical monitoring of lower extremity neurological status in a post
operative patient should be undertaken diligently.