Exacerbating of chronic disease as risk factor for surgical delay in patients with spinal metastases

Abstract

Object. Determining the degree of influence of exacerbation of somatic pathology on the shift of the terms of surgical treatment in patients with spinal metastases. Methods. A retrospective analysis of the data of 210 patients with spinal neoplasms undergoing treatment in the period from 2013 to 2017 was performed. In this cohort, the average terms from the moment of determining the indications for surgical treatment to surgery, as well as the frequency of somatic pathology, which was a contraindication to surgical treatment, were analyzed Results. The average time from the moment of determining the indications for surgical treatment to surgery in the main cohort of patients was 46.4 days (12 - 86). An aggravation of the gastrointestinal tract pathology with the formation of ulcers or erosion of the stomach and duodenum was the most common cause of delayed surgical treatment (41%). At the same time, 86% of cases of this complication led to a shift in the timing of surgery to 1 month. The presence of foci of chronic infection statistically significantly determined the greatest duration of the preoperative period (> 1 month) in 52.6% of cases. Conclusion. An aggravation of the gastrointestinal tract pathology and the presence of foci of chronic infection in patients with metastatic spinal lesions are the most frequent contraindications to surgical treatment and the reasons for the increase in the duration of the preoperative period.