• Mathieu Laflamme, Alessandro Gasbarrini, Laurence D Rhines, Aron Lazary, Ziya L Gokaslan, Jeremy J Reynolds, Alessandro Luzzati, Alexander C Disch, Dean Chou, Michelle J Clarke, Feng Wei, Chetan Bettegowda, Y Raja Rampersaud, Stefano Boriani, John H Shin, Elizabeth Lord, Daniel M Sciubba, Ilya Laufer, Arjun Sahgal, Charles G Fisher, Nicolas Dea, and AO Spine Knowledge Forum Tumor.
• Division of Neurosurgery, Department of Surgery, CHU de Québec - Université Laval, Québec City, Québec, Canada.
• Neurosurgery. 2025 Feb 5.

Background And ObjectivesAggressive resection for primary tumors of the spine are associated with a high rate of adverse events (AEs), but the impact of AEs on patient-reported outcomes (PROs) remains unknown and is critical to the shared decision-making. Our primary objective was to assess the impact of surgical AEs on PROs using an international registry. Assessing the impact on clinical outcomes and identifying risk factors for AEs were our secondary objectives.MethodsPatients who underwent surgery for a primary spinal tumor were selected through the Primary Tumor Research and Outcomes Network. Our primary outcome was the impact of AEs on PROs at 3 and 12 months after surgery (measured with Spinal Oncology Study Group Outcomes Questionnaire, Short-Form 36, and EuroQol 5 Dimension). We also assessed the impact on clinical outcomes (local control, surgical margins, readmission, reoperation, and mortality). We stratified our results according to severity of AEs, histology, and type of resection.Results374 patients met inclusion criteria (219 males/155 females). The mean age of the cohort was 48.7 years. The most frequent histology was chordoma (37.3%) followed by chondrosarcoma (8.8%). Sixty-seven patients (17.9%) experienced at least 1 intraoperative AE and 117 patients (31.3%) had at least 1 postoperative AE within 3 months. Overall, 159 patients (42.5%) experienced AEs. The readmission rate was significantly higher in patients who experienced AEs (Any AE: 10.1% vs no AE: 1.9% within 3 months; P = <0.001). PROs were not significantly affected by AEs in most questionnaires. Local control, risk of reoperation, mortality, and achieving preplanned margins were similar between AE groups.ConclusionThe rate of surgical AEs is considerable in this population. Surgical AEs seem to be associated with a higher number of readmissions, but do not seem to result in significant differences in PROs or in a higher risk of reoperation, mortality, and failure to achieve preplanned margins.Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Congress of Neurological Surgeons.

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