A sea-change occurred in the field of spine surgery in 2005 following the landmark
publication of Patchell et al [
[1]
]. regarding the efficacy of spine surgery for restoration of ambulatory function in
patients with spinal metastatic disease. In the succeeding 15 years, enthusiasm grew
for surgical interventions as a standard treatment option for patients with spinal
metastases [
[2]
]. Several investigations touted that surgery not only preserved ambulatory ability
but also improved survival [
3
,
4
,
5
,
6
]. There was a concern that many of these investigations were confounded by selection
bias and controversy remains regarding the utility of spine surgery in subsets of
patients with spinal metastases based on baseline neurologic status [
[7]
]. To address this, we planned an analysis that accounted for confounding by indication
and compared patients treated operatively and nonoperatively for spinal metastases
within the Prospective Observational study of Spinal metastasis Treatment (POST) [
- Schoenfeld AJ
- Bensen GP
- Blucher JA
- Ferrone ML
- Balboni TA
- Schwab JH
- et al.
The cost-effectiveness of surgical intervention for spinal metastases: a model-based
evaluation.
J Bone Joint Surg Am. 2021; (Online ahead of print. PMID: 34288901)https://doi.org/10.2106/JBJS.21.00023
[2]
,
[8]
]. We hypothesized that patients treated surgically would have superior one-year survival
to those managed nonoperatively.To read this article in full you will need to make a payment
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References
- Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial.Lancet. 2005; 366: 643-648
- Design of the prospective observational study of spinal metastasis treatment (POST).Spine J. 2020; 20: 572-579
- Rapid improvements in pain and quality of life are sustained after surgery for spinal metastases in a large prospective cohort.Br J Neurosurg. 2016; 30: 337-344
- Cost-utility analysis of surgery and radiotherapy for symptomatic spinal metastases in a belgian specialist center.World Neurosurg. 2019; 125: e537-e543
- Surgery and radiotherapy for symptomatic spinal metastases is more cost effective than radiotherapy alone: a cost utility analysis in a U.K. Spinal Center.World Neurosurg. 2018; 109: e389-e397
- Quality of life and cost-utility of surgical treatment for patients with spinal metastases: prospective cohort study.Int Orthop. 2017; 41: 1265-1271
- The cost-effectiveness of surgical intervention for spinal metastases: a model-based evaluation.J Bone Joint Surg Am. 2021; (Online ahead of print. PMID: 34288901)https://doi.org/10.2106/JBJS.21.00023
- Prospective validation of a clinical prediction score for survival in patients with spinal metastases: the New England Spinal Metastasis Score.Spine J. 2021; 21: 28-36
- Reflection on modern methods: Trial emulation in the presence of immortal-time bias. Assessing the benefit of major surgery for elderly lung cancer patients using observational data.Int J Epidemiol. 2020; 49: 1719-1729
- Regression Models for Categorical Dependent Variables Using STATA.2nd Edition. STATA Press, College Station, TX2006
Article info
Publication history
Published online: February 15, 2022
Accepted:
February 4,
2022
Received in revised form:
February 2,
2022
Received:
November 1,
2021
Footnotes
FDA device/drug status: Not applicable
Author disclosures: GXX: Nothing to disclose. JEC: Grants: OREF (F); MLF: Grants: OREF (F). AJS: Grants: OREF (F, paid directly to institution); Grants: NIH-NIAMS (G, paid directly to institution); Royalties: Wolters Kluwer (E); Royalties: Springers Nature (A); Grants: DoD (H, paid directly to institution).
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