Predictors of ambulatory function after decompressive surgery for metastatic epidural spinal cord compression.

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Predictors of ambulatory function following decompressive surgery for metastatic epidural spinal cord compression Kaisorn L. Chaichana, B.S. Graeme Woodworth, M.D. Matthew McGirt, M.D. Daniel M. Sciubba, M.D. Ali Bydon, M.D. Ziya L. Gokaslan, M.D. Department of Neurosurgery Johns Hopkins University School of Medicine

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Methods Patients operated on from 1995-2005 were retrospectively reviewed (98 total patients) Inclusion criteria = 18 years of age Tissue-proved diagnosis of solid primary tumor MRI evidence of spinal cord displacement Lesion located in a single area Exclusion criteria Multiple, discrete decompressive lesions Radiosensitive tumors (i.e. lymphoma, leukemia, multiple myeloma, germ cell tumors) Aim of the surgery: circumferentially decompress the spine

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Methods (continued) Information recorded: Demographics and co-morbidities Clinical presentation MRI findings Intra-operative findings Post-operative neurological outcomes Primary endpoint: ambulatory ability Minimizes observer bias Critical quality of life indicator (Jain, Am J Phys Med Rehabil. 86: 387, 2007) Uniformly included in all clinical documentation Statistical analysis – multivariate logistical regression analysis Factors associated with maintaining ambulatory status Factors associated with regaining ambulatory status

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Patient Population 78 total patients met inclusion/exclusion criteria

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Operative results

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Pre-Operative Ambulators vs. Non-Ambulators

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Predictors of Maintaining Ambulation

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Predictors of Regaining Ambulation

CORD PROLAPSE

ADVERSE CEREBRAL OUT...

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	kaisorn@jhmi.edu 5 Years ago.



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