Project status: Complete.

About one-third of cancer patients eventually develop metastases of the disease to the spine, leading to reduction in mobility as the cancer progresses through the spinal space. Although such metastatic cases are often treated surgically, quality of life tradeoffs in operations for spinal metastases are not well understood. Operating on the spine can restore ambulatory status and reduce pain, but it also poses the risk of post-operative mortality. Currently, patients make their treatment decisions without conclusive data to influence their choice. Clinicians stand to benefit from clarifying the factors, which include ambulatory status, that drive treatment decision-making and influence treatment outcomes in this patient population.

The STrIDeS (Spinal metastasis TReatment In DEtermining ambulatory Status) study examines independent ambulation in patients with spinal metastases. Analyses of medical record data from patients treated either operatively or non-operatively evaluate the factors associated with independent ambulation. A second, qualitative study investigates how patients engage in decision-making regarding treatment for spinal metastases and the role that valuation of different health states plays in this process.

The STrIDeS population includes individuals treated at either Brigham and Women’s or Massachusetts General Hospital.