Objectives
The primary surgical goals when treating a spinal metastasis are usually pain relief and preservation of ambulatory function. Minimally invasive techniques have become popular, being associated with less morbidity and mortality than conventional open surgeries.
Materials and Methods
Between April 2012 and September 2016, 15 consecutive patients underwent percutaneous pedicle screw fixation (PPSF) to treat spinal metastases. We retrospectively analyzed prospectively collected data, including visual analog scale (VAS) pain scores, Frankel scale scores, and complications.
Results
Fifteen patients (8 males, 7 females; mean age 61 years) underwent surgery under general anesthesia. PPSF was performed on all patients, and two with poor bone quality underwent cement augmentation of the manipulated vertebra(e) just prior to pedicle screw insertion. Seven patients underwent fixation plus distraction (indirect decompression via ligamentotaxis) and two laminectomies (direct decompression) of the spinal cord. Two patients developed screw pullout requiring revision surgery. One patient died 7 days after surgery from liver cirrhosis and sepsis. All patients reported that pain was reduced after surgery. After surgery, 12 patients regained ambulatory capacity. Nine patients died during follow-up; the mean overall survival time was 14.1 months.
Conclusions
PPSF is a safe and minimally invasive palliative surgery option for patients with spinal metastases.

Purpose
There were few available data regarding the prognosis after the surgical treatment for spinal metastases from non-small cell lung cancer (NSCLC) despite its great frequency. The aim of this study was to investigate the prognostic factors for patients who underwent the surgical treatment for spinal metastases from NSCLC.
Materials and Methods
Eighty-seven patients who underwent surgical treatment for spinal metastases from NSCLC were followed up semi-prospectively. There were 43 patients with metastatic spinal cord compression (MSCC) and 44 patients without MSCC. The prognosis analysis was performed according to 3-categorical variables: patients’ , oncologic, and treatments’ factors. Major complications and mortality rate were recorded. The impact of postoperative chemotherapy was evaluated separately.
Results
The overall survival time was median 6.8 months. Postoperative ECOG-PS (0-2 vs. 3, 4) was shown as a significant prognostic factors in both MSCC and non-MSCC groups with HR (hazards ratio) of 2.46 and 2.54, respectively. Major complications developed in 26 patients and 30-day mortality rate was 8.0%. The presence of major complications was also prognostic factor in both groups with HR of 2.55 and 4.47. Earlier surgery within 72 hours showed better prognosis in MSCC group with HR of 2.46. Patients who underwent postoperative chemotherapy survived longer significantly than those who couldn’t with median survival time of 12.0 vs 2.8 months.
Conclusions
Postoperative ECOG-PS and complications were significant prognostic factors in both groups and earlier surgery in MSCC group. The postoperative chemotherapy was another independent prognostic factor affecting the survival time