Distress in Patients with Metastatic Spine Disease Undergoing Surgical Intervention

Introduction: Cancer patients often experience high distress, especially during the perioperative period, but there is a dearth of research on distress in metastatic spine disease (MSD). This study assesses pre- and post-operative distress in MSD patients undergoing surgery and examines the relationship between distress and sociodemographic factors.

Methods: We retrospectively reviewed electronic medical records of MSD patients who underwent surgery from 2015 to 2023. Preoperative (within 30 days) and postoperative (30 and 90 days) distress levels were measured using the National Comprehensive Cancer Network Distress Thermometer (NCCN-DT). The association between distress and sex, age, race/ethnicity, and marital status was evaluated using Chi-Square tests.

Results: We identified 397 patients with complete NCCN-DT scores. Nearly half (46.6%) were female, and 68.3% were White, with a mean age of 62 years. Preoperatively, the mean (SD) distress score was 3.5 (3.1), with 46.4% of patients reporting moderate to severe distress. The mean (SD) distress score at 30-days postop was 3.2 (3.0), with 43.8% of patients reporting moderate to severe distress. At 90-days post-op, the mean distress score was 2.2 (2.5) with 23.8% of patients reporting moderate to severe levels. Non-White patients had significantly higher preoperative distress than their White counterparts (p=0.03).

Conclusion : Distress is common in MSD patients undergoing surgery, with nearly half reporting moderate to severe distress preoperatively, and significant distress persisting through the first month post-op. These findings underscore the need for timely psychosocial interventions and highlight race-based disparities in distress, calling for targeted support for vulnerable groups.