Are they too old? Surgical treatment for metastatic epidural spinal cord compression in patients aged 65 years and older.

AbstractObjectives:We aimed to assess the efficacy of surgical decompression of metastatic epidural spinal cord compression (MESCC) in patients ≧65 years and review our multidisciplinary surgical decision-making process.Methods:We identified all patients operated for MESCC from August 2008 to June 2012. Patients ≧65 years, with a single area of cord compression, back/radicular pain, neurological signs of cord compression, surgery within 48 hours after onset of MESCC-related paraplegia, and follow-up for ≧1 year or until death were included. Files were reviewed retrospectively. The requirement for informed consent was waived. Neurological status was assessed with the American Spinal Injury Association (ASIA) Impairment Scale (AIS). Duration of ambulation and survival were assessed with Kaplan–Meier and Cox regression analysis.Results:Twenty-one patients met inclusion criteria (11 women/10 men; mean age 73 years, range 65–87). All presented with debilitating back/neck pain. Ten patients (48%) were not ambul...