Management of spinal tumors: decompression vs stabilization – retrospective clinical experience

Abstract

The management of spinal tumors requires personalized treatment based on neurological status, lesion location, and extent. This retrospective study analyzes the clinical experience of patients with spinal tumors, comparing the effectiveness of decompression and stabilization techniques in their treatment. Analysis of the effectiveness of decompression and stabilization techniques in the management of spinal tumors, clinical outcomes in the period 2020-2023, neurological improvement and spinal stability. The retrospective study included 42 patients diagnosed with spinal tumors (14 primary, 28 metastatic), operated on during 2020–2023, within the INN "Diomid Gherman". Patients were evaluated using the ASIA scale, Karnofsky score and SINS score for tumoral spinal instability. Postoperative surveillance was for a minimum of 6 months. The interventions consisted of: Spinal decompression by laminectomy(n = 30), segmental transpedicular stabilization (n = 35), with or without interbody cage reconstruction (n = 12), vertebroplasty with acrylic cement (n = 7) in selected cases. Obtaining the results: Neurological improvement (≥1 ASIA grade) in 71% of cases. Vertebral stability restored in all cases treated with implants. Minor postoperative complications in 4 patients (9.5%): superficial infection, screw migration without neurological deficit, 6-month survival rate: 76% (with postoperative integrated adjuvant oncological therapies). Surgery for spinal tumors should be individualized, combining decompression and stabilization based on neurological status and lesion location. Transpedicular fixation, often with corpectomy or vertebroplasty, is essential for stability. Treatment requires a multidisciplinary approach.