Study investigating the role of skeletal muscle mass estimation in metastatic spinal cord compression

Gakhar, H. and Dhillon, Amandeep Kaur and Blackwell, J. and Hussain, K. and Bommireddy, R. and Klezl, Z. and Williams, John P. (2015) Study investigating the role of skeletal muscle mass estimation in metastatic spinal cord compression. European Spine Journal, 24 (10). pp. 2150-2155. ISSN 1432-0932

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Abstract

Background

Age-related loss of functional muscle mass is associated with reduced functional ability and life expectancy. In disseminated cancer, age-related muscle loss may be exacerbated by cachexia and poor nutritional intake, increasing functional decline, morbidity and accelerate death. Patients with spinal metastases frequently present for decompressive surgery with decision to operate based upon functional assessment. A subjective assessment of physical performance has, however, been shown to be a poor indicator of life expectancy in these patients. We aimed to develop an objective measure based upon lean muscle mass to aid decision making, in these individuals, by investigating the association between muscle mass and 1-year survival.

Methods

Muscle mass was calculated as total psoas area (TPA)/ vertebral body area (VBA), by two independent blinded doctors from CT images, acquired within 7 days of spinal metastases surgery, at the mid L3 vertebral level. Outcome at 1 year following surgery was recorded from a prospectively updated metastatic spinal cord compression database.

Results

86 patients were followed for 1 year, with an overall mortality of 39.5 %. Mortality rates at 1 year were significantly high among patients in the lowest quartile of muscle mass, compared with those in the highest quartile (57.1 vs 23.8 %, p = 0.02).

Conclusion

Death within 1 year in individuals with spinal metastases is related to lean muscle mass at presentation. Assessment of lean muscle mass may inform decision to operate in patients with spinal metastases.

Item Type: Article
Additional Information: The final publication is available at Springer via http://dx.doi.org/10.1007/s00586-015-4050-7.
Keywords: Metastatic spinal cord compression; Sarcopenia; Lean muscle mass
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Medical Sciences and Graduate Entry Medicine
Identification Number: 10.1007/s00586-015-4050-7
Depositing User: Eprints, Support
Date Deposited: 01 Aug 2017 11:13
Last Modified: 12 Oct 2017 23:29
URI: http://eprints.nottingham.ac.uk/id/eprint/44551

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