Emergency neoplastic spinal cord compression without known histology: should we operate?
Among 80 patients with emergency presentation of neoplastic spinal cord compression without known histology, 90% ultimately had histology, neurological status, or instability favorable for surgery, thus affirming the surgeons' choice to operate. However, 1 in 10 patients could have potentially been treated with radiation and/or systemic treatment alone. Two patients (3%) had primary bone tumors, foregoing the chance of a negative margin resection. Not knowing histology preoperatively was independently associated with decreased overall survival. These results provide empirical data for a challenging yet not uncommon situation for spine surgeons and reinforce the importance of knowing histology prior to spine tumor surgery when safe and feasible.
Authors
- Julian Lugo-Pico
- Iyan Younus (ORCID: https://orcid.org/0000-0002-9764-4245)
- Anthony E. Bishay (ORCID: https://orcid.org/0000-0002-6057-3770)
- Ranbir Ahluwalia (ORCID: https://orcid.org/0000-0002-8194-3056)
- Sameer Sundrani (ORCID: https://orcid.org/0000-0002-1939-0462)
- Scott L. Zuckerman (ORCID: https://orcid.org/0000-0003-2951-2942)
- Harsh B. Jain (ORCID: https://orcid.org/0000-0001-9396-3989)
- Byron F. Stephens (ORCID: https://orcid.org/0000-0001-5397-5344)
- Tyler Zeoli (ORCID: https://orcid.org/0000-0002-3929-5964)
- Amir Mohamad Abtahi (ORCID: https://orcid.org/0000-0001-6756-7421)
- Keyan Peterson (ORCID: https://orcid.org/0000-0001-9662-3680)
- Hani Chanbour
Institutions
- Vanderbilt University (US)
- Vanderbilt University Medical Center (US)
Publication Details
- Journal
- Neurosurgical FOCUS
- Published
- 2025-05-01
- DOI
- https://doi.org/10.3171/2025.2.focus24989
- Citations
- 2
- Primary Topic
- Management of metastatic bone disease
- Type
- article
- Field-Weighted Citation Impact
- 4.01