Abstract：
BACKGROUND: Both cancer diagnosis/treatment modality and surgical technique for the spine have been developed recently. Nationwide trends in the surgical treatment for metastatic spinal tumors have not been reported in the last decades. This study aimed to examine recent trends in the surgical treatment for spinal metastasis and in-hospital patient outcomes using nationwide administrative hospital discharge data.
METHODS: The Diagnosis Procedure Combination database from 2012 to 2020 was used to extract data from patients who underwent surgical procedures for spinal metastasis with the number of non-metastatic spinal surgery at the institutions that have performed metastatic spine surgeries at least one case in the same year. Trends in the surgical treatment for spinal metastasis, patients\' demographics, and in-hospital mortality/outcomes were investigated.
RESULTS: This study analyzed 10,321 eligible patients with spinal metastasis. The surgical treatment for spinal metastasis increased 1.68 times from 2012 to 2020, especially in fusion surgery, whereas the proportion of metastatic spinal surgery retained with a slight increase in the 2%s. Distributions of the primary site did not change, whereas age was getting older. In-hospital mortality and length of stay decreased over time (9.9-6.8%, p < 0.001; 37-30 days, p < 0.001). Postoperative complication and unfavorable ambulatory retained stable and slightly decreased, respectively.
CONCLUSIONS: During the last decade, surgical treatment for spinal metastasis, especially fusion surgery, has increased in Japan. In-hospital mortality and length of stay decreased. Recent advances in cancer treatment and surgical techniques might influence this trend.
METHODS: The Diagnosis Procedure Combination database from 2012 to 2020 was used to extract data from patients who underwent surgical procedures for spinal metastasis with the number of non-metastatic spinal surgery at the institutions that have performed metastatic spine surgeries at least one case in the same year. Trends in the surgical treatment for spinal metastasis, patients\' demographics, and in-hospital mortality/outcomes were investigated.
RESULTS: This study analyzed 10,321 eligible patients with spinal metastasis. The surgical treatment for spinal metastasis increased 1.68 times from 2012 to 2020, especially in fusion surgery, whereas the proportion of metastatic spinal surgery retained with a slight increase in the 2%s. Distributions of the primary site did not change, whereas age was getting older. In-hospital mortality and length of stay decreased over time (9.9-6.8%, p < 0.001; 37-30 days, p < 0.001). Postoperative complication and unfavorable ambulatory retained stable and slightly decreased, respectively.
CONCLUSIONS: During the last decade, surgical treatment for spinal metastasis, especially fusion surgery, has increased in Japan. In-hospital mortality and length of stay decreased. Recent advances in cancer treatment and surgical techniques might influence this trend.
摘要：
背景：最近已经开发了用于脊柱的癌症诊断/治疗方式和手术技术。在过去的几十年中，转移性脊柱肿瘤的手术治疗在全国范围内的趋势尚未报道。这项研究旨在使用全国行政医院出院数据检查脊柱转移的外科治疗和住院患者预后的最新趋势。
方法：使用2012年至2020年的诊断程序组合数据库从接受脊柱转移手术的患者中提取数据，其中非转移性脊柱手术的数量在同一年进行了至少一例脊柱转移手术的机构。脊柱转移瘤的外科治疗趋势,患者人口统计学，并调查了院内死亡率/结局.
结果：本研究分析了10,321例脊柱转移患者。从2012年到2020年，脊柱转移瘤的手术治疗增加了1.68倍，尤其是融合手术，而转移性脊柱手术的比例保持在2%s的略有增加。主站点的分布没有改变，而年龄越来越大。住院死亡率和住院时间随着时间的推移而下降（9.9-6.8%，p<0.001；37-30天，p<0.001)。术后并发症和不良门诊保持平稳，略有减少，分别。
结论：在过去的十年中，脊柱转移瘤的外科治疗,尤其是融合手术,在日本有所增长。住院死亡率和住院时间减少。癌症治疗和外科技术的最新进展可能会影响这一趋势。
方法：使用2012年至2020年的诊断程序组合数据库从接受脊柱转移手术的患者中提取数据，其中非转移性脊柱手术的数量在同一年进行了至少一例脊柱转移手术的机构。脊柱转移瘤的外科治疗趋势,患者人口统计学，并调查了院内死亡率/结局.
结果：本研究分析了10,321例脊柱转移患者。从2012年到2020年，脊柱转移瘤的手术治疗增加了1.68倍，尤其是融合手术，而转移性脊柱手术的比例保持在2%s的略有增加。主站点的分布没有改变，而年龄越来越大。住院死亡率和住院时间随着时间的推移而下降（9.9-6.8%，p<0.001；37-30天，p<0.001)。术后并发症和不良门诊保持平稳，略有减少，分别。
结论：在过去的十年中，脊柱转移瘤的外科治疗,尤其是融合手术,在日本有所增长。住院死亡率和住院时间减少。癌症治疗和外科技术的最新进展可能会影响这一趋势。
