To explore the clinical characteristics of metastatic epidural spinal cord compression in patients aged 60 years and older accepted separation surgery.

We identified old patients with spinal metastases who underwent separation surgery from January 2014 to December 2018 in the 960 hospital. The data included gender, age, pathology, involvement, stability of the spine, epidural spinal cord compression, neurological function evaluation, tumor treatment, internal fixation, operative time, bleeding volume, chronic illness, and postoperative complications Statistics analyze were performed separately.

Thirty-three patients met inclusion criteria (19 women/14 men; mean age 65.2 years, range 60-75). The Frankel neurological function classification included 2 cases of grade A, 1 case of grade B, 2 cases of grade C, 19 cases of grade D, and 9 cases of grade E. The average SINS was 11.6 points, range 8-16 points. ESCC classification included 2 cases with stage 1b, 2 cases with 1c, 13 cases with 2, and 16 cases with 3. There were 17 patients with chronic illness and other 16 patients without. All patients underwent pedicle screw fixation, and the average number of screws used was 7.2 (range 4-9). Only seven patients underwent bone cementation after tumor curettage under direct vision. The median amount of bleeding was 600 ml (range 150-2, 500 ml). The median operation time was 168 min (range 94-277 min). Perioperative complications occurred in 3 patients after surgery. 29 patients had symptomatic improvement after surgery, and the improvement rate was 87.9%.

With careful patient selection, separation surgery may achieve good symptom improvement under controllable trauma.