Surgical Timing in Patients with Vertebral Metastases and Neurological Impairment in the Public Health System: A Case Series and Literature Review
Abstract
Introduction: Vertebral metastases account for 40% of all bone metastases and are often complicated by spinal cord compression, which constitutes an emergency. Decompression surgery within the first 48 hours has been proposed as the most effective strategy. In the public health system of the Autonomous City of Buenos Aires (CABA), Argentina, the care of these patients is affected by the heterogeneity of the healthcare system and the resources available. Materials and Methods: A retrospective, descriptive case series study was conducted at a public hospital in CABA between 2018 and 2023. Patients aged >18 years with vertebral metastases and neurological deficits who underwent surgery were included. Patients with incomplete data or no neurological deficits were excluded. Clinical, functional, and prognostic variables were analyzed using descriptive statistics. Results: Fourteen patients were included (12 women and 2 men; median age, 59 years). The main causes of surgical delay were a lack of surgical supplies, delayed diagnosis, and poor treatment adherence. Conclusions: Problems related to surgical delays in patients with vertebral metastases and neurological impairment were documented to raise awareness of this issue. A lack of surgical supplies and delayed diagnosis were identified as the main areas requiring improvement.Downloads
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