Clinical Outcomes of Patients Who Underwent Palliative Surgery for Spinal Metastases With and Without a History of Radiation: A Multicenter Registry Study
Study DesignA multicenter retrospective cohort study using prospectively collected data.ObjectivesRadiotherapy (RT) is the standard treatment for spinal metastases; however, the optimal timing of RT in patients requiring surgery remains unclear. This study compared the clinical outcomes of palliative surgery according to RT timing.MethodsAmong 413 patients screened across 35 centers, 146 patients with spinal metastases limited to the spine who underwent palliative surgery were included. Patients were classified into three groups based on RT timing: preoperative RT, postoperative RT, and no RT. Short-term outcomes were compared among the three groups.ResultsOf the 146 patients (preoperative RT: n = 42; postoperative RT: n = 59; no RT: n = 45), baseline characteristics and postoperative functional outcomes were comparable between the postoperative RT and no RT groups. Preoperative opioid use was significantly more frequent in the preoperative RT group. Postoperative complications were more common in the preoperative RT group. Functional outcomes improved in all groups; however, greater improvements in pain and numbness were observed in the nonpreoperative RT group than in the preoperative RT group, with a significant difference noted in numbness improvement.ConclusionsPostoperative recovery after palliative surgery was largely comparable among the three groups. Although greater improvements in pain and numbness were observed in patients who did not receive preoperative RT, the clinical impact of preoperative RT in patients with mechanical instability remains uncertain. Postoperative wound complications were more frequent in the preoperative RT group, but these findings should be interpreted with cautiously given the limited number of events.
Authors
- Tsutomu Oshigiri
- Kazuyuki Watanabe (ORCID: https://orcid.org/0000-0003-0286-2440)
- Masahiro Funaba (ORCID: https://orcid.org/0000-0002-8006-2230)
- Yutaro Kanda (ORCID: https://orcid.org/0000-0001-5538-5516)
- Haruki Funao (ORCID: https://orcid.org/0000-0001-8192-8342)
- Chizuo Iwai (ORCID: https://orcid.org/0000-0002-4352-351X)
- Toshio Nakamae (ORCID: https://orcid.org/0000-0002-9790-3884)
- Takuya Iimura
- Yuki Shiratani (ORCID: https://orcid.org/0000-0003-4832-6491)
- Takeo Furuya
- Masaaki Paku (ORCID: https://orcid.org/0000-0002-7564-7293)
- Kenta Watanabe (ORCID: https://orcid.org/0000-0003-0827-7381)
- Hirokazu Inoue (ORCID: https://orcid.org/0000-0001-8420-6724)
- Toru Funayama (ORCID: https://orcid.org/0000-0002-7325-4357)
- Daisuke Yamabe (ORCID: https://orcid.org/0000-0002-6769-716X)
- Hiroyuki Tominaga (ORCID: https://orcid.org/0000-0001-8701-2343)
- Norihiko Takegami (ORCID: https://orcid.org/0000-0002-4677-3450)
- HIDETOMI TERAI
- Kousei Miura (ORCID: https://orcid.org/0000-0001-7826-184X)
- Noboru Taniguchi (ORCID: https://orcid.org/0000-0002-1391-144X)
- Hiroaki Manabe (ORCID: https://orcid.org/0000-0002-8979-5860)
- Shuji Watanabe
- Hirofumi Shimada
- Kazu Kobayakawa
- Ko Hashimoto
- Akihiko Hiyama
- Eiki Shirasawa
- Shoji Seki
- Koji Uotani
- Kazuo Nakanishi
- Ichiro Kawamura
- Hirokatsu Sawada
- Kenichiro Kakutani
- Shiro Imagama
- Koji Matsumoto
- Narihito Nagoshi
- Takashi Kaito
- Shinji Tanishima
- Hiroaki Nakashima
- Hidenori Suzuki
- Gen Inoue
- Yuta Goto
- Akinobu Suzuki
- Atsushi Kimura
- Satoshi Kato
- Hiroshi Moridaira
- Hideaki Nakajima
- Yohei Takahashi
- Takaki Shimizu
- Bungo Otsuki
- Koji Akeda
- Takashi Hirai
- Masayuki Ishihara
- Hiromi Sasaki
Institutions
- Kanazawa University (JP)
- Nihon University (JP)
- Kagoshima University (JP)
- University of Fukui (JP)
- Hiroshima University (JP)
- Kansai Medical University (JP)
- Fukushima Medical University (JP)
- Tokai University (JP)
- Kyushu University (JP)
- Sapporo Medical University (JP)
- University of Tsukuba (JP)
- Jichi Medical University (JP)
- Chiba University (JP)
- Yamaguchi University (JP)
- Mie University (JP)
- Iwate Medical University (JP)
- Oita University (JP)
- Kawasaki Medical School (JP)
- Tohoku University (JP)
- Keio University (JP)
- Nagoya City University (JP)
- Shanghai Institute for Science of Science (CN)
- Okayama University Hospital (JP)
- Gifu University Hospital (JP)
- Kagoshima City Hospital (JP)
- Kyoto University Hospital (JP)
- Jichi Medical University Hospital (JP)
- University of Toyama (JP)
- Osaka Metropolitan University (JP)
- Institute of Science Tokyo (JP)
- Tottori University (JP)
- Nagoya University (JP)
- Kitasato University (JP)
- Kobe University (JP)
- Dokkyo Medical University (JP)
- International University of Health and Welfare (JP)
- Tokushima University (JP)
- The University of Osaka (JP)
Publication Details
- Journal
- Global Spine Journal
- Published
- 2026-02-14
- DOI
- https://doi.org/10.1177/21925682261426935
- Primary Topic
- Management of metastatic bone disease
- Type
- article
- Field-Weighted Citation Impact
- 0.00