Objective: Metastases to the spine occur in about 40% of patients with cancer which has a major effect on their physical condition and prognosis. We have assessed the results of wide decompression and fixation for spinal stabilization in 38 patients with symptomatic SCC to determine the prognostic factors for successful surgical decompression and fixation. Methods: We retrospectively reviewed the records of 38 patients(26 men, 12 women; mean age, 57.4 years) with sympto- matic SCC due to metastatic spinal tumors who underwent surgical treatment, between May 1995 and June 2006. All patients also received steroid treatment. Results: The predominant site of the primary tumor was the lungs(11 patients, 28.9%). Before surgery, 4(10.5%) patients had grade I, 2(5.3%) had grade II, 8(21.1%) had grade III, and 24(63.1%) had grade IV paresis, and their mean duration of motor weakness was 13.3 days. Thirty one(81.6%) patients showed motor improvement postoperatively. All ambulatory grade IV patients could ambulate postoperatively. Six of 8(75%) grade III patients could ambulate after surgery. However, of the grade I and II patients, only one(16.7%) could ambulate. There were no morbidities related to surgery, including hardware failure, screw pullout or spinal cord injury. Conclusion: Preoperative motor grade is an important prognostic factor for motor improvement, with grade III or higher critical for recovery of ambulatory function for patients with metastatic SCC. Wide decompression, maximal tumor removal and screw fixation is more effective and safer than decompression alone.
