Improvement of sleep quality in isolated metastatic patients with spinal cord compression after surgery

World Journal of Surgical Oncology, 2023 · DOI: https://doi.org/10.1186/s12957-023-02895-0 · Published: January 11, 2023

Sleep Medicine Oncology

Simple Explanation

This study investigates how surgery affects sleep quality in patients with spinal cord compression caused by cancer that has spread to the spine. Two surgical methods, TES and PSRS, were compared to see which led to better sleep. The study found that both surgical treatments improved sleep quality, and factors like pain relief and reduced spinal cord compression were associated with better sleep. The researchers suggest that timely and effective surgery to relieve pressure on the spinal cord and control tumor recurrence are crucial for improving sleep in these patients.

Study Duration

December 2017 to May 2021

Participants

49 patients with isolated spinal metastasis

Evidence Level

Not specified

Key Findings

1
Patients with spinal cord compression caused by metastatic disease experienced significantly improved sleep quality after undergoing TES and PSRS treatments.
2
A decrease in ESCC scale value of > 1 was identified as a favorable contributing factor associated with PSQI improvement, indicating that greater decompression of the spinal cord correlates with better sleep.
3
The study suggests that preventing tumor recurrence through effective local tumor control achieved by TES and PSRS can indirectly improve sleep quality.

Research Summary

This study aimed to evaluate changes in sleep quality (QoS) in isolated metastatic patients with spinal cord compression following surgical treatments (TES and PSRS) and to identify factors contributing to QoS improvement. The results showed a significant improvement in the total Pittsburgh Sleep Quality Index (PSQI) score 6 months after surgery, with factors like reduced pain, improved performance status, and decreased spinal cord compression contributing to this improvement. The conclusion emphasizes the importance of timely surgical decompression and recurrence control in improving sleep quality for patients with spinal cord compression caused by metastatic disease.

Practical Implications

Surgical Intervention

TES and PSRS are effective surgical options for improving sleep quality in patients with spinal cord compression due to metastatic disease.

Pain Management

Effective pain management strategies, including postoperative analgesics, are crucial for enhancing sleep quality in these patients.

Spinal Cord Decompression

Achieving adequate decompression of the spinal cord is essential for improving sleep quality, as indicated by the favorable impact of a decrease in ESCC scale value.

Study Limitations

1
The retrospective nature of this study is its main limitation.
2
All patients enrolled in our study underwent surgical intervention, and no control group was treated without surgery.
3
Solitary spinal metastasis, as a rare disease with strict surgical inclusion criteria, led to a small sample size in our study.

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