Prognosis of Single Spinal Metastatic Tumors: Predictive Value of the Spinal Instability Neoplastic Score System for Spinal Adverse Events
10.31616/asj.2018.12.5.919
- Author:
Sam Yeol CHANG
1
;
Jae Hong HA
;
Sang Gyo SEO
;
Bong Soon CHANG
;
Choon Ki LEE
;
Hyoungmin KIM
Author Information
1. Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea. hmkim21@gmail.com
- Publication Type:Original Article
- Keywords:
Neoplasm metastasis;
Spinal Instability Neoplastic Score;
Compression fractures;
Spinal cord compression
- MeSH:
Cohort Studies;
Diagnosis;
Fractures, Compression;
Humans;
Multivariate Analysis;
Neoplasm Metastasis;
Prognosis;
Proportional Hazards Models;
Retrospective Studies;
Spinal Cord Compression;
Survival Rate
- From:Asian Spine Journal
2018;12(5):919-926
- CountryRepublic of Korea
- Language:English
-
Abstract:
STUDY DESIGN: This was a retrospective cohort study. PURPOSE: We evaluated the predictive value of the Spinal Instability Neoplastic Score (SINS) system for spinal adverse events (SAEs) in patients with single spinal metastatic tumor. OVERVIEW OF LITERATURE: The SINS system was developed to assess spinal instability in patients with single metastatic spinal tumor. However, the system’s potential predictive value for SAEs has been partially studied. METHODS: This system was applied to a retrospective cohort of 78 patients with single spinal metastatic tumors. The patients underwent surgical treatment and were postoperatively followed up for at least 2 years or until death. The attribution of each score and total SINS to SAE (vertebral compression fracture [VCF] and spinal cord compression [SCC]) occurrence was assessed using the Cox proportional hazards model. RESULTS: SAEs occurred on average 7 months after diagnosis of spinal metastasis. The mean survival rate post diagnosis was 43 months. Multivariate analysis using the Cox proportional hazards model revealed that the pain (p=0.029) and spinal alignment (p=0.001) scores were significantly related to VCF occurrence, whereas the pain (p=0.008) and posterolateral involvement (p=0.009) scores were related to SCC occurrence. CONCLUSIONS: Among the components of the SINS system, while pain and spinal alignment showed a significant association with VCF occurrence, pain and posterolateral involvement showed association with SCC occurrence.