Steroids in the Management of Preoperative Neurological Deficits in Metastatic Spine Disease: Results From the EPOSO Study

AO Spine Knowledge Forum Tumor

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Patients presenting with neurological deficit secondary to metastatic epidural spinal cord compression (MESCC) are often treated with surgery in combination with high-dose corticosteroids. Despite steroids being commonly used, the evidence regarding the effect of corticosteroids on patient outcomes is limited. The objective of this study was to describe the effect of corticosteroid use on preoperative neurological function in patients with MESCC. Methods: Patients who underwent surgery between August 2013 and February 2017 for the treatment of spinal metastases and received steroids to prevent neurologic deficits were included. Data regarding demographics, diagnosis, treatment, neurological function, adverse events, health-related quality of life, and survival were extracted from an international multicenter prospective cohort. Results: A total of 30 patients treated surgically and receiving steroids at baseline were identified. Patients had a mean age of 58.2 years (standard deviation, 11.2 years) at time of surgery. Preoperatively, 50% of the patients experienced deterioration of neurological function, while in 30% neurological function was stable and 20% improved in neurological function. Lengthier steroid use did not correlate with improved or stabilized neurological function. Postoperative adverse events were observed in 18 patients (60%). Patients that stabilized or improved neurologically after steroid use showed a trend towards improved survival at 3-and 24-month postsurgery. Conclusion: This study described the effect of steroids on preoperative neurological function in patients with MESCC. Stabilization or improvement of preoperative neurological function occurred in 50% of the patients.

Original languageEnglish (US)
Pages (from-to)43-50
Number of pages8
JournalNeurospine
Volume19
Issue number1
DOIs
StatePublished - Mar 2022
Externally publishedYes

Keywords

  • Metastasis
  • Neurological deficits
  • Outcomes
  • Spinal cord compression
  • Spine
  • Steroids

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Fingerprint

Dive into the research topics of 'Steroids in the Management of Preoperative Neurological Deficits in Metastatic Spine Disease: Results From the EPOSO Study'. Together they form a unique fingerprint.

Cite this