Surgical management of spinal metastases involving the cervicothoracic junction: results of a multicenter, European observational study

OBJECTIVE Surgical management of spinal metastases at the cervicothoracic junction (CTJ) is highly complex and relies on case-based decision-making. The aim this multicentric study was to describe surgical procedures for CTJ provide guidance clinical management. METHODS Patients eligible were those with (C7–T2) who had been consecutively treated in 2005–2019 7 academic institutions across Europe. Spine Instability Neoplastic Score, neurological function, status, medical history, data each patient retrospectively assessed. divided into four groups: 1) posterior decompression only, 2) fusion, 3) anterior corpectomy 4) 360° fusion. Endpoints complications, revision rate, survival. RESULTS Among 238 patients inclusion study, 37 included group 1 (15%), 127 2 (53%), 18 3 (8%), 56 4 (24%). Mechanical pain predominant symptom (79%, 189 patients). complications occurred 16% (group 1), 20% 2), 11% 3), 18% 4). Of these, hardware failure (HwF) led 8 cases. overall complication rate 34%. In-hospital mortality 5%. CONCLUSIONS Posterior fusion most frequently used technique. Care should be taken choose instrumentation techniques that offer highest possible biomechanical load-bearing capacity avoid HwF. Since high, prevention in-hospital seems crucial reduce mortality.