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Toronto (Nov. 22, 2015) – Spinal decompression surgery, when used as a complementary adjunct to radiation and chemotherapy, has been shown to provide immediate and sustained improvement in pain, neurological, functional, and health related quality of life (HRQoL) outcomes in patients with Metastatic Epidural Spinal Cord Compression (MESCC) with an estimated life expectancy of at least three months.
Published today in the Journal of Clinical Oncology, the study sponsored by AOSpine North America (AOSNA), examined the survival and clinical outcomes in 142 surgically treated patients with a single symptomatic MESCC lesion causing hard to control pain, neurological deficits, or clear/imminent instability of the spinal column that can lead to paralysis. Patients were followed for at least 12 months after their operation.
Researchers found that in comparison to their pre-operative status, MESCC patients treated with decompression surgery as part of their treatment plan experienced significant pain relief. In addition, a greater proportion of patients were able to walk independently and had improved bladder control and continence. Overall, patients demonstrated substantial HRQoL improvements as measured by several validated indices.
"This is a fragile patient population that is notably suffering from extreme pain caused by the spread of cancer cells to the spine," said Dr. Michael Fehlings, neurosurgeon and Director, Spine Program, Krembil Neuroscience Centre who was the principal investigator of the study. "While surgery is increasingly being used in this patient population, there is still limited evidence as to its impact on quality of life.
"Our findings provide the necessary data to support spinal decompression surgery as a treatment option since it offers these patients rapid, substantial and sustained pain relief that improves their overall quality of life."
MESCC occurs when cancer metastasizes to the spine, extends into the epidural space and compresses the spinal cord. It is a dreaded complication of malignant cancers and affects approximately five per cent of patients with the disease. If left untreated, MESCC can progress to cause debilitating pain, paralysis, gait instability, sensory loss, as well as bladder, bowel and sexual dysfunction.
The AOSNA MESCC study was a prospective, multi-center, observational, cohort study involving ten North American centres that are members of the AOSNA Clinical Research Network, and were selected for their high volume of patients presenting with spinal metastases and their expertise in the management of this condition. It is anticipated that this work will have an impact on the care of individuals with metastatic cancer with spinal involvement.
The Krembil Neuroscience Centre (KNC), located at Toronto Western Hospital, is home to one of the largest combined clinical and research neurological facilities in North America. Since opening in 2001, KNC has been recognized as a world leader through its research achievements, education and exemplary patient care. The centre focuses on the advancement, detection and treatment of neurological diseases and specializes in movement disorders, dementias, stroke, spinal cord injury, blinding eye diseases, epilepsy and cancer-related conditions. For more information please visit
University Health Network consists of Toronto General and Toronto Western Hospitals, the Princess Margaret Cancer Centre, and Toronto Rehabilitation Institute. The scope of research and complexity of cases at University Health Network has made it a national and international source for discovery, education and patient care. It has the largest hospital-based research program in Canada, with major research in cardiology, transplantation, neurosciences, oncology, surgical innovation, infectious diseases, genomic medicine and rehabilitation medicine. University Health Network is a research hospital affiliated with the University of Toronto.
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