[Functional results after surgical treatment of long-lasting epidural compression of the neural structures in patients with spinal tumors].

UNLABELLED: Surgical treatment of cancer patients with severe neurological symptoms is a complex multidisciplinary problem that often does not lead to a positive disease's outcome. It is also not always possible to perform operative treatment in a short time frame after paraparesis debut.

OBJECTIVE

To evaluate the impact of the timeframe from the onset of neurological disorders to surgical decompression in patients with plegia, caused by the neural structures compression by the spinal tumor, on the disease's outcome.

MATERIAL AND

METHODS

An observation of 34 patients who underwent surgery for epidural tumor compression of the spinal neural structures from 2005 to 2021 was presented. Functional deficit was evaluated by the Karnofsky, ASIA AIS scales. All patients had paraplegia and sensitivity impairment (ASIA AIS A, B) before the operation. Primary sources were the mammary gland (7.7%), prostate (15%), kidney (27%), multiple myeloma (3.8%), lungs, liver and plasmocytoma (by 7.7% each), stomach, colon and chondrosarcoma (3.8%), other tumors (15.8%).

RESULTS

Surgical treatment demonstrates a satisfactory result in the form of partial or complete restoration of the neurological deficit in a quarter of cases (23.5%) with no significant impact on life expectancy. Each day of persistent compression of the neural structures reduces the probability of neurological deficit regression by 4%.

CONCLUSION

Performance of surgery in patients with severe neurological disorders 27 days or more after the debut has an extremely low probability of restoring the ability to move independently. Diagnostic awareness in the detection of spinal tumors and timely surgical treatment of patients with the threat of developing epidural compression of the neural structures allow to reduce the risk of disability and improve the quality of life of patients.