Acute transverse spinal cord syndrom due to spinal metastasis - Etiology and developement of treatment recommendations

• Conditions: Tetraplegia, unspecified; C79.5; G82.0; G82.1; G82.2; G82.3; G82.4; G82.5; Secondary malignant neoplasm of bone and bone marrow; Flaccid paraplegia

• Registration Number: DRKS00024045
• Lead Sponsor: Klinik für Orthopädie und Unfallchirurgie und Klinik für Neurochirurgie - Universitätsklinik Freiburg

Brief Summary

Pathologic vertebral fractures are more common in patients with MESCC than previously described. However, they do not predict severe paralysis on their own. In contrast, complete spinal cord compression (ESCC grade 3) was found to be a significant predictor of severe impairments. Further prognostic factors identified were patient age, duration of paralysis, and SINS values. These should be implemented in future follow-up algorithms, to help patients avoid neurological complications. The postoperative results demonstrated in this study show that surgical concepts relying on stabilization and decompression are capable to reverse paralysis already in the acute recovery stage. Due to the complex decision-making, cases should always be discussed by tumor boards.

Detailed Description

Not available

Study Timeline

• Study Start: 2021-01-31
• Study Completion: 2022-03-01
• Results First Posted: 2023-02-01
• Last Update Posted: 19 August 2024

Recruitment & Eligibility

• Status: Complete
• Sex: All
• Target Recruitment: 136

Inclusion Criteria

1. Spinal metastases with epidural spinal cord compression
2. Spnal metastases with consecutive acute transverse spinal cord syndrome
3. Operated at our institution from january first 2012 to august 31st 2019

Exclusion Criteria

1. Previous operation at the examined part of the spine
2. Intracranial metastases
3. No vertebral metastases
4. Missing information (CT- or MRI- scans or relevant informations from patient history)

Study & Design

• Study Type: observational
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Transverse syndrom of the spinal cord described by the ASIA Scale (American Spinal Injury Association (ASIA) Impairment Scale)

Secondary Outcome Measures

Name	Time	Method
- Pathologic fracture<br>- Spinal cord crompression using the ESCC-Scale (Epidural Spinal Cord Compression Scale)