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 prognosis. 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.