Prevalence of Spinal Metastasis in Neurosurgical Procedures: A Descriptive Study

Abstract

Objective: This study sought to identify the prevalence of operations for spinal epidural neoplastic metastases relative to other spine and neurosurgical operative procedures. Methods: This study was descriptive and involved a retrospective review of data collected from patients who underwent neurosurgeries between February 1997 and January 2015 at a single quaternary hospital. The examined population was distributed across five descriptive categories to perform numerical distributions among neurosurgical operative procedures. Results: A total of 12,802 neurosurgical procedures were identified. These procedures were classified as follows: Skull and brain,11,192 (87.42%); spinal column and spinal nervous tissue, 1462 (11.42%); and peripheral nerves, 148 (1.16%). Surgical procedures for the 1462 (100%) cases of spinal column and spinal nervous tissue diseases were distributed by nosology as follows: Degenerative intervertebral disk and spondylosis, 768 (52.54%); neoplastic, 279 (19.08%); traumatic, 221 (15.11%); congenital, 163 (11.14%); infectious and inflammatory, 27 (1.85%); and vascular, 4 (0.28%). With respect to the distribution of the 279 (100%) surgical procedures for spinal column and spinal nervous tissue neoplastic diseases, 124 (44.44%) procedures were for intradural neoplasms, and 155 (55.56%) procedures were for epidural spinal column neoplasms. The 155 (100%) operations for epidural neoplastic diseases were distributed into two groups: Primary epidural neoplasms, 42 (27.10%); and secondary epidural neoplasms, 113 (72.90%). Spinal column epidural neoplastic metastases (secondary neoplasms) represented 0.88% of the 12,802 neurosurgical procedures. Conclusions: Surgical procedures for spinal metastasis are uncommon with respect to all neurosurgical operative procedures. Trend analysis reveals an unchanging trend of prevalence for these procedures.

Prevalence of spinal metastases: a descriptive cross-sectional update and literature review / Prevalência em metástases espinais: atualização de estudo transversal descritiva e revisão da literatura

“…The three studies eligible for analysis identified internal validity integrity and homogeneity in sample datasets in accordance to the number of patients in each spinal neoplasm prevalence group (11,(14)(15) . Oxford CEBM level of evidence-based medicine criteria analyses (13) classified clinical appraisal quality as level 4 in the cross-sectional study (11) and level 3 in the two case-series studies (14)(15) . Randomized controlled trials were absent in this literature search.…”

“…This secondary outcome indicated that spinal intradural neoplasms were prevalent when compared with spinal metastases, the latter the most common histologic tumor type group. Comparisons in spinal neoplasms census concerning the systematic literature review indicated that 191 (22.05%) patients were operated for spinal metastases, 83 (9.59%) for epidural primary neoplasms and 592 (68.36%) for intradural neoplasms, in regard to the 3 reports cohorts of 866 (100%) patients operated for spinal and spinal tissue neoplasms (11,(14)(15) .…”

“…Daniel, Veiga(2016) (11) compares surgical prevalence of spinal metastases relative to neurosurgical procedures, primary spinal and intradural spinal tissue neoplasms in addition to other spinal surgeries. This epidemiological cross-sectional descriptive study is conducted in a single neurosurgical division situated in a teaching quaternary hospital in the city of São Paulo, Brazil from 1997 to 2015.…”

“…The primary author collected the study data from the Divisions registry files. In the conceptual framework for the studied population, research data was organized into descriptive categories for numerical comparisons (11) . Premise supplied some evidence through inductive reasoning derived from multiple observations that approximately 10% of symptomatic patients with spinal epidural metastases in the advanced cancer stage were managed with palliative surgery.…”

“…Research design was distributed into two distinct methods: Descriptive cross-sectional and, systematic research method for literature review. This study's primary outcome is an update of a previously published descriptive cross-sectional survey for prevalence of spinal epidural metastases in neurosurgical procedures (11) . Furthermore, the study's secondary outcome is a literature review for surgical prevalence of spinal epidural metastasis among spinal and spinal tissue neoplasms in the neurosurgical context.…”