General Session: Tumor, Trauma, Infection - Hall F

Presented by: S. Horn

Author(s):

S. Horn(1), G. Poorman(1), J. Tishelman(1), N. Stekas(1), N. Frangella(1), F. Segreto(1), J. Moon(1), O. Behery(1), N. Shepard(1), B. Diebo(2), S. Vira(1), P. Passias(1)

(1) New York University Langone Orthopedic Hospital, Division of Spinal Surgery, New York, NY, United States
(2) University Hospital of Brooklyn, Department of Orthopaedic Surgery, New York, NY, United States

Abstract

Introduction: Surgical treatment for spinal metastasis has benefited from improvements in surgical techniques. The trends in treatment and outcomes for spinal metastasis surgery have not been well-established in a large pediatric population.

Methods: Retrospective review of KID Inpatient Database (KID) 20003-2012. Patients with metastatic spinal tumors undergoing spinal surgery, and age 0-20 were identified in the KID database. Trends for spinal metastases treatment and patient hospital outcomes were analyzed using weight-adjusted ANOVAs.

Results: 333 patients were identified in the KID database with surgical treatment for spinal metastases. The top five primary diagnoses were metastatic brain/spinal cord tumor (19.8%), metastatic nervous system tumor (15.9%), metastatic bone cancer (13.2%), spinal cord tumor (4.2%), and tumor of ventricles (3.0%). There was an increased incidence of spinal metastasis diagnoses from 2003-12 (from 88.5 to 117.9 per 100,000; p< 0.001). as well as an increased trend in the incidence of surgical treatment for spinal metastasis from 2003-2012 (p=0.014). The average age of these patients was 10.19 ± 6.33 years old and 38.4% of these patients were female. The average CCI was 8.11 ± 1.37 and the average hospital length of stay was 17.34 ± 24.36. Average CCI increased over time (2003: 7.87 ± 1.40, 2012: 8.44 ± 1.39; p=0.006). The most common surgeries these patients underwent are excision of spinal cord/meninges lesions (69.1%), exploration and decompression of spinal canal (38.1%). Length of hospital stay and in-hospital mortality did not change over time (17.34-18.04 days, p=0.337; 1.6%-2.9%, p=0.801). 10.5% of patients underwent a posterior fusion and 22.2% of patients had at least one complication (nervous system, respiratory, dysphagia, infection most common). The overall complication rate remained stable over time (23.4%-21.8%, p=0.952).

Conclusions: Surgical treatment for spinal metastasis in the last decade has increased, though the complication rates, in-hospital mortality, and length of stay have remained stable.