P46. Comparison of outcomes of open and percutaneous spinal fixation techniques for the treatment of metastatic spinal tumors

Indications for surgical treatment of metastatic spine tumors include neural decompression and fixation for restoration of spinal stability. Due to the frail nature of spinal oncology patients, the use of percutaneous techniques has become more widespread in addition to traditional open decompression. Percutaneous fixation combined with ‘mini-open’ decompression can allow for both stabilization and decompression through smaller, relatively muscle sparing approaches. These allows for smaller incisions and the potential for less surgical pain, faster recovery, and reduction of wound healing issues. The decision of whether to use open or percutaneous fixation techniques may be influenced by the degree of instability, the amount of epidural disease and extent of decompression needed, as well as performance status and medical morbidities, and the patient's ability to tolerate an open procedure. We wish to compare patients that have undergone open or percutaneous spinal fixation techniques for the treatment of metastatic spine tumors to compare indications and outcomes. N/A N/A N/A All spinal fixation procedures performed between 2018 and 2022 for the treatment of metastatic spine tumors at a single institution was retrospectively reviewed. Patient demographics, primary malignancy, performance (ECOG) and spinal instability neoplastic scores (SINS) were collected, as well as trending of pain scores and overall survival. Univariate cox proportional model analysis was used to assess for overall survival. In our cohort, there were 156 open fixation procedures and 67 percutaneous procedures performed. The most common source of primary malignancy was lung (21.5%), followed by breast (16.1%), and hematological malignancy (15.2%). Poor overall survival was associated with head and neck malignancies (HR 7.25 CI 95% 3.09-17.01 p