• Jin Hoon Park and Sang Ryong Jeon.
• Department of Neurological Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Seoul, Korea.
• Spine. 2013 Jun 1;38(13):E798-802.

Study DesignRetrospective review of medical records.ObjectiveTo describe pre- and postoperative ambulatory status and lower limb motor power, and compare characteristics of patients with metastatic spinal cord compression (MSCC) who were ambulatory at 48 hours postoperatively with those of patients with MSCC who were nonambulatory.Summary Of Background DataPreoperative motor power of the lower extremities is a predictor of postoperative ambulatory status in patients with MSCC.MethodsWe retrospectively evaluated the medical records of 102 consecutive patients with MSCC who presented for decompressive surgery with lower extremity weakness between January 1997 and December 2010. A single surgeon classified the preoperative and 48-hour postoperative motor power of the lower extremities on a 6-point scale. Ambulation status was determined 48 hours after surgery and patients were classified as ambulatory (including normal ambulation, ambulation with aid, and ambulation without aid) or nonambulatory. Demographic and clinical characteristics were compared between patients who were ambulatory and those who were nonambulatory at 48 hours postoperatively.ResultsMotor power was improved 1.05 ± 0.73 grades after operation. Two-thirds of patients who were preoperatively classified as nonambulatory were ambulatory at 48 hours postoperatively. The only significantly different affecting factor between the postoperative ambulatory group and the nonambulatory group was preoperative lower extremity power and preoperative capability of ambulation. In addition, grade III of lower extremity motor power was significant criteria for postoperative ambulation.ConclusionWe recommend aggressive decompressive surgery in patients with MSCC if preoperative lower extremity motor power is at least grade III, although all groups of preoperative lower extremity motor power had 1 or more patients who returned to ambulation.Level Of Evidence3.

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