Introduction
The most common and potentially fatal complication in surgeries for spinal metastasis is wound problems. This study aimed to assess the incidence and risk factors for wound revision following the surgical treatment of spinal metastases.
Methods
This retrospective cohort study analyzed data from the Korean National Health Insurance Service claims databases, which cover the entire population of South Korea. A total of 3,001 participants, who underwent one of five surgical treatments (corpectomy, decompression and instrumentation, instrumentation only, decompression only, and vertebroplasty) for newly diagnosed spinal metastasis between 2009 and 2017, were identified. Cox regression analysis was performed to determine the risk factors for wound revision among various factors.
Results
In this study, a total of 197 cases (6.6%) of wound revision were found. The only significant differences between the group that underwent wound revision and the group that did not were observed in Charson's comorbidity index (CCI) and the surgical method used. There was no significant difference in the administration of radiotherapy before and after surgery between the two groups. The CCI was higher in the wound revision group. Regarding surgical methods, the adjusted hazard ratios (HR) with 95% confidence intervals (CI) for 'decompression only', 'corpectomy', 'instrumentation and decompression', and 'instrumentation only' were 1.3 (0.7, 2.7), 2.2 (1.2, 3.8), 2.2 (1.3, 3.6), and 2.4 (1.2, 4.7) respectively, compared to the vertebroplasty group, with a significant trend observed (P for trend = 0.02).
Discussion
The study identified the severity of medical comorbidities and the type of surgical method as key risk factors for wound revision in patients with metastatic spinal tumors.