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Objective To investigate whether visceral metastases have a significant impact on survival in patients with metastasis‐related spinal cord compression (MSCC), and to determine the difference in prognosis between patients with and without visceral metastases. Methods Three institutional databases were searched to identify all patients who had undergone spinal surgery for spinal metastases between March 2002 and June 2010. Data on patient characteristics including pre‐ and post‐operative medical conditions, were collected from medical records or by telephone follow‐up. Survival data were obtained either from medical records or by searching a governmental cancer registry. Results The mean age of study patients was 59.6 ± 10.5 years (range, 18–84 years), of whom 102 were male and 67 female. The median and mean postoperative survival times were 7.0 ± 0.5 (95% CI 6.0–8.0) months and 12.6 ± 1.2 (95% CI 10.1–15.0) months, respectively, in all patients, being 5.0 ± 0.5 (95% CI 4.0–6.0) months and 10.8 ± 2.4 (95% CI 6.1–15.5) months, respectively, for patients with visceral metastases and 7.0 ± 0.8 (95% CI 5.4–8.6) months and 13.0 ± 1.4 (95%CI 10.3–15.6) months, respectively, for patients without visceral metastases (P = 0.87). These survival times did not differ significantly between groups. Multivariate Cox proportional hazard regressions showed that visceral metastases had no statistically significant association with survival (P = 0.277), whereas rate of growth of primary tumor (P = 0.003), preoperative Karnofsky performance status (KPS) (P

Few reports are available on the posterior transfacet approach for the treatment of central calcified thoracic disk herniation (TDH). The objective of this study was to assess outcomes and complications in a consecutive series of patients with TDH who underwent posterior transfacet decompression and diskectomy with segmental instrumentation and fusion. The data for 27 patients (16 males and 11 females) were retrospectively reviewed and analyzed, including clinical presentation, blood loss, operative time, pre- and postoperative complications, visual analog scale, Japanese Orthopedic Association (JOA) score, and Frankel grade. All patients underwent trans-facet decompression and segmental instrumentation with interbody fusion. Mean patient age at surgery was 55.2 years (range, 21-81 years). Average follow-up was 30±19 months (range, 12-50 months). All patients were successfully treated with posterior decompression and segmental instrumentation with interbody fusion. Average operative time was 124±58 minutes (range, 87-180 minutes). Mean blood loss was 439±225 mL (range, 300-1500 mL). Average pre- and postoperative JOA scores were 4.12±0.87 and 8.01±0.97 points, respectively. Overall JOA scores showed a significant postoperative improvement. Overall recovery rates were excellent in 12 patients, good in 6, fair in 5, and unchanged in 1. No patient was classified as worse. The results suggest that the posterior approach using a special L-shaped osteotome is feasible. No major complications occurred while achieving adequate decompression for central calcified TDH. [ABSTRACT FROM AUTHOR]