Prognostic factors in metastatic spinal cord compression: A prospective study using multivariate analysis of variables influencing survival and gait function in 153 patients
Prognostic factors in metastatic spinal cord compression: A prospective study using multivariate analysis of variables influencing survival and gait function in 153 patients
复制标题
DOI：
10.1016/s0360-3016(99)00333-8
复制
发表时间：
2000-03-15
影响因子：
7
通讯作者：
Kreiner, S
中科院分区：
文献类型：
--
作者：
Helweg-Larsen, S;Sorensen, PS;Kreiner, S
目的：基于一个非常大的患者队列，前瞻性随访至少一年或直到死亡，我们分析了各种临床和放射学变量对治疗后动态功能和生存的预后意义。方法和材料：在31/2年的时间里，我们前瞻性地纳入了153例因转移性疾病诊断为脊髓压迫的连续患者。由同一神经科医生对患者进行至少11个月的定期神经学检查或直至死亡。分析5个变量对治疗后步态功能及生存时间的预后意义。原发肿瘤的类型直接影响诊断的主要恶性肿瘤之间的间隔和脊髓的发生压缩(p < 0.0005),在诊断的动态函数在时间(p = 0.016),有一个明确的myelographic堵塞和步态功能的程度之间的相关性(p = 0.000)和步态功能和感觉障碍(p = 0.000),最后的步态是依赖于步态功能诊断时(p < 0.0005),诊断后的生存时间直接取决于从原发肿瘤诊断到脊髓受压的时间（p = 0.002）、诊断时的行走功能（p = 0.018）和治疗后的行走功能。结论：治疗前运动功能是影响治疗后步态功能的主要因素。生存时间较短，特别是在非门诊患者中，只有通过立即治疗恢复非门诊患者的步态功能才能改善生存时间。(C) 2000 Elsevier Science Inc.；
Purpose: Based on a very large patient cohort followed prospectively for at least a year or until death, we analyzed the prognostic significance of various clinical and radiological variables on posttreatment ambulatory function and survival.Methods and Materials: During a 31/2-year period we prospectively included 153 consecutive patients with a diagnosis of spinal cord compression due to metastatic disease. The patients were followed with regular neurological examinations by the same neurologist for a minimum period of 11 months or until death. The prognostic significance of five variables on gait function and survival time after treatment was analyzed,Results: The type of the primary tumor had a direct influence on the interval between the diagnosis of the primary malignancy and the occurrence of spinal cord compression (p < 0.0005), and on the ambulatory function at time of diagnosis (p = 0.016), There was a clear correlation between the degree of myelographic blockage and gait function (p = 0.000) and between gait function and sensory disturbances (p = 0.000), The final gait was dependent on the gait function at time of diagnosis (p < 0.0005), Survival time after diagnosis depended directly on the time from primary tumor diagnosis until spinal cord compression (p = 0.002), on the ambulatory function at the time of diagnosis (p = 0.018), and on the ambulatory function after treatment.Conclusions: The pretreatment ambulatory function is the main determinant for posttreatment gait function. Survival time is rather short, especially in nonambulatory patients, and can only be improved by restoration of gait function in nonambulatory patients by immediate treatment. (C) 2000 Elsevier Science Inc.