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KMID : 1143720110070020057
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Korean Journal of Neurotrauma
2011 Volume.7 No. 2 p.57 ~ p.62
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Comparison of Peri-Operative Effectiveness between Anterior-Posterior Approach and Posterior Only Approach in Metastatic Thoracic Spinal Tumor
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Kim Ji-Hoon
Park Jin-Hoon
Jeon Sang-Ryong
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Abstract
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ObjectivesThis paper shows the appropriate method of metastatic thoracic spine cord surgery by comparing survival, pain scale (Numeric Rating Scale) and Barthel index which are considered as the prognosis of surgery in anterior-posterior approach and posterior approach.
Methods:The author has researched 61 cases of metastatic thoracic spine tumor operations; 10 cases of anterior-posterior approach and 51 cases of posterior approach, performed in this institution for 8 years from January 2001 to December 2008. The author has compared improvement of neurologic symptoms after surgery (improvement in ambulation), survival, pain scale (Numeric Rating Scale) and functional outcome according to Barthel index. Statistical analysis was done using Kaplan Meyer Survival analysis, Log-Rank test and Mann-Whitney test.
Results:The average age of patients who received surgery were 56.8 years (35-72 years) and 53.9 years (26-75 years), in the anterior-posterior approach group and the posterior approach group respectively. The Barthel index increased from average 68.7 to 72.9 in the anterior-posterior approach group and 61.6 to 69.3 in the posterior approach group (p=0.027, p<0.001). Improvement in pain were 40% in the anterior-posterior approach group and 51% in the posterior approach on 1 month post-operation. Both posterior decompression and screw fixation were performed in both operations, and it has shown that there were no significant difference in survival, improvement of ambulation, improvement in pain and functional outcome compared with the anterior-posterior approach.
Conclusion:Considering similar survival and clinical outcomes, posterior approach can minimize morbidity related with operation.
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KEYWORD
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Metastatic spinal tumor, Anterior-posterior approach, Posterior approach, Prognosis
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