Objective: Improvement of the results of treatment of vertebral tumors with neural compression by means of analyzing the authors’ experience.Material and methods: The study included 151 patients with primary and metastatic vertebral tumors, operated in the neurosurgical departments of three large medical institutions from 01.01.2014 to 31.12.2020.Results: Most of the patients underwent palliative interventions. Radical surgery (marginal or wide resection of the tumor) was performed in 8 (5%) patients. Surgical treatment as the only method of treatment was used in 75 (50%) cases, combined treatment was used in 42 (28%) people, complex treatment – in 34 (22%). The immediate results of treatment of 91% of patients were characterized by the absence of negative dynamics in the neurological status and in 50% of cases by positive dynamics in the functional state. Among patients with malignant tumors and a traced catamnesis, the one-year survival rate was 66%, three-year – 52%, five-year – 47%. The median overall survival rate was 12.8 months, the median event-free survival rate was 12.55 months.Conclusion: The use of non-radical interventions in the surgery of vertebral tumors with neural compression expands the possibilities of minimizing surgical trauma, while maintaining the neurological and improving the functional status of the patient.

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Background. Epidural spinal cord compression (ESCC) is the most common neurological complication in metastatic spinal tumours.Materials and methods. The study included 87 spinal malignancy patients operated within 01.01.2014–30.09.2021. All patients had a  type of palliative decompressive and stabilising surgery: standard posterior access (SPA, 55  patients), minimally invasive posterior access (MPA, 22 patients) or anterior access (AA, 10 patients).Results. The patient cohorts did not differ significantly by the duration of surgery, length of hospital stay, rates and types of postoperative complications. The AA cohort revealed a statistical difference by intraoperative blood loss. A Karnofsky performance status was statistically improved post- vs. pre-surgery (p < 0.05) at no significant change of Frankel neurological function status (p > 0.05). A Kaplan — Meier curve analysis showed no significant survival rate variation among the surgical techniques. Discussion. Our results suggest that posterior access interventions should be considered optimal. We report no statistical difference in the postoperative neurological and performance status dynamics between both cohorts, which encourages the MPA use in all patients with minimal epidural compression.Conclusion. Posterior access with cytoreductive tumour removal in anterior spinal cord compression is advantageous over anterior surgery. A posterior access surgery with minimal spinal canal decompression is recommended in all patients with grade 1 tumoural epidural compression.