Corrigendum to: “The Neurology-Stability-Epidural compression assessment: A new score to establish the need for surgery in spinal metastases” Clin. Neurol. Neurosurg. 195 (2020 Aug) 105896

We have previously reported an algorithm that invokes several imaging modalities in the early detection of metastatic and benign disease of the spine in patients with cancer (J Clin Oncol 4:576, 1986). The development of new lesions (shown by Tc99m bone scans) in cancer patients with normal neurological examinations is further evaluated with plain radiographs, spinal computed tomography (CT), and CT myelography (CT-M). Of 60 patients in the original study, 28% were diagnosed as having only benign disease and the remainder had spinal metastases. Thecal sac impingement was seen in 47% of patients with metastatic disease and disruption of the posterior vertebral cortex was noted in all patients with epidural compression. We now report the 2-year follow-up of 55 of these patients. Without treatment, the 17 patients diagnosed with benign disease have shown no evidence of local failure in the spine and median survival is greater than 27 months. Thirty-eight patients diagnosed with spinal metastases had a median survival time of 16.9 months. Radiation therapy directed by CT-M findings provided pain relief in 78% of patients with back pain and metastatic disease. No patient, including 19 with thecal sac impingement, developed clinical myelopathy. These results demonstrate the usefulness of an imaging algorithm for the early identification and distinction of spinal metastatic disease and benign disease in patients with cancer.

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COMPLICATIONS OF SURGICAL TREATMENT OF SPINAL METASTASES

Coluna/Columna ◽

10.1590/s1808-185120212004255227 ◽

2021 ◽

Vol 20 (4) ◽

pp. 300-304

Author(s):

Priscila Barile Marchi Candido ◽

Fernanda Maris Peria ◽

Vinicius Nogueira Toledo ◽

Herton Rodrigo Tavares Costa ◽

Helton Luiz Aparecido Defino

Keyword(s):

Retrospective Study ◽

Surgical Treatment ◽

Spinal Metastasis ◽

Spinal Metastases ◽

Tumor Location ◽

Karnofsky Performance Scale ◽

Tumor Type ◽

Level Of Evidence ◽

Epidural Compression ◽

Performance Scale

ABSTRACT Objectives: To evaluate the complications of surgical treatment in a group of patients with spinal metastasis with epidural compression, undergoing surgical treatment. Methods: This is a comparative retrospective study (level of evidence III), which evaluated 96 patients with spinal metastases undergoing surgical treatment. Intra- and postoperative complications were obtained from the patients’ medical records and correlated with the following clinical characteristics: tumor type, tumor location, neurological deficit, age, number of affected vertebrae, Tokuhashi scale, Tomita scale, Karnofsky performance scale, and type of approach. Results: Complications of surgical treatment were observed in 29 (30.20%) patients. Surgical wound infection was the most frequent complication, observed in 15% of patients. Conclusions: Surgical treatment of spinal metastases presents complications in about 30% of patients and their occurrence should be considered in the treatment planning, weighing the risks and benefits for achieving the treatment goals. Level III evidence; Retrospective Study.

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Quantitative MRI for Functional Assessment Following SBRT for Spinal Metastases

Case Medical Research ◽

10.31525/ct1-nct04248543 ◽

2020 ◽

Author(s):

Keyword(s):

Functional Assessment ◽

Spinal Metastases ◽

Quantitative Mri

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Intradural tumor recurrence after resection of extradural metastasis: a rare but potential complication of intraoperative durotomy

Journal of Neurosurgery Spine ◽

10.3171/2014.3.spine13896 ◽

2014 ◽

Vol 20 (6) ◽

pp. 734-739 ◽

Cited By ~ 3

Author(s):

Manish K. Kasliwal ◽

Lee A. Tan ◽

John E. O'Toole

Keyword(s):

Tumor Recurrence ◽

Spinal Metastasis ◽

Spinal Metastases ◽

Intramedullary Tumor ◽

Local Tumor ◽

Local Tumor Recurrence ◽

Tumor Dissemination ◽

Intradural Tumor ◽

Clinical Consequences ◽

Clinical Awareness

Spinal metastases are the most common of spinal neoplasms and occur predominantly in an extradural location. Their appearance in an intradural location is uncommon and is associated with a poor prognosis. Cerebrospinal fluid dissemination accounts for a significant number of intradural spinal metastases mostly manifesting as leptomeningeal carcinomatoses or drop metastases from intracranial tumors. The occurrence of local tumor dissemination intradurally following surgery for an extradural spinal metastasis has not been reported previously. The authors describe 2 cases in which local intradural and intramedullary tumor recurrences occurred following resection of extradural metastases that were complicated by unintended durotomy. To heighten clinical awareness of this unusual form of local tumor recurrence, the authors discuss the possible etiology and clinical consequences of this entity.

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Radiation Therapy without Surgery for Spinal Metastases: Clinical Outcome and Prognostic Factors Analysis for Pain Control

Global Spine Journal ◽

10.1055/s-0032-1326948 ◽

2012 ◽

Vol 2 (3) ◽

pp. 137-141

Author(s):

Akira Matsumura ◽

Manabu Hoshi ◽

Masatsugu Takami ◽

Takahiko Tashiro ◽

Hiroaki Nakamura

Keyword(s):

Radiation Therapy ◽

Prognostic Factors ◽

Clinical Outcome ◽

Pain Control ◽

Spinal Metastases ◽

Factors Analysis

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Management of recurrent or progressive spinal metastases: reirradiation techniques and surgical principles

Neuro-Oncology Practice ◽

10.1093/nop/npaa045 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. i45-i53

Author(s):

Rupesh Kotecha ◽

Nicolas Dea ◽

Jay S Detsky ◽

Arjun Sahgal

Keyword(s):

Progressive Disease ◽

Organs At Risk ◽

Methodological Approach ◽

Spinal Metastases ◽

Multidisciplinary Care ◽

Rehabilitation Medicine ◽

Surgical Approaches ◽

Mechanical Instability ◽

Conventional Radiotherapy ◽

Treated Site

Abstract With the growing incidence of new cases and the increasing prevalence of patients living longer with spine metastasis, a methodological approach to the management of patients with recurrent or progressive disease is increasing in relevance and importance in clinical practice. As a result, disease management has evolved in these patients using advanced surgical and radiotherapy technologies. Five key goals in the management of patients with spine metastases include providing pain relief, controlling metastatic disease at the treated site, improving neurologic deficits, maintaining or improving functional status, and minimizing further mechanical instability. The focus of this review is on advanced reirradiation techniques, given that the majority of patients will be treated with upfront conventional radiotherapy and further treatment on progression is often limited by the cumulative tolerance of nearby organs at risk. This review will also discuss novel surgical approaches such as separation surgery, minimally invasive percutaneous instrumentation, and laser interstitial thermal therapy, which is increasingly being coupled with spine reirradiation to maximize outcomes in this patient population. Lastly, given the complexities of managing recurrent spinal disease, this review emphasizes the importance of multidisciplinary care from neurosurgery, radiation oncology, medical oncology, neuro-oncology, rehabilitation medicine, and palliative care.

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Letter to the Editor concerning “The importance of timely treatment for quality of life and survival in patients with symptomatic spinal metastases” by van Tol FR, et al. [Eur Spine J (2020): DOI 10.1007/s00586-020–06,599-x]

European Spine Journal ◽

10.1007/s00586-021-06823-2 ◽

2021 ◽

Author(s):

Kai Huang

Keyword(s):

Quality Of Life ◽

Spinal Metastases ◽

Letter To The Editor ◽

Timely Treatment

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Prospective cohort study of surgical outcome for spinal metastases in patients aged 70 years or older

The Bone & Joint Journal ◽

10.1302/0301-620x.102b12.bjj-2020-0566.r1 ◽

2020 ◽

Vol 102-B (12) ◽

pp. 1709-1716

Author(s):

Yutaro Kanda ◽

Kenichiro Kakutani ◽

Yoshitada Sakai ◽

Takashi Yurube ◽

Shingo Miyazaki ◽

...

Keyword(s):

Quality Of Life ◽

Performance Status ◽

Eastern Cooperative Oncology Group ◽

Spinal Metastases ◽

Palliative Surgery ◽

Advanced Age ◽

Health State ◽

Survival Times ◽

The Mean

Aims With recent progress in cancer treatment, the number of advanced-age patients with spinal metastases has been increasing. It is important to clarify the influence of advanced age on outcomes following surgery for spinal metastases, especially with a focus on subjective health state values. Methods We prospectively analyzed 101 patients with spinal metastases who underwent palliative surgery from 2013 to 2016. These patients were divided into two groups based on age (< 70 years and ≥ 70 years). The Eastern Cooperative Oncology Group (ECOG) performance status (PS), Barthel index (BI), and EuroQol-5 dimension (EQ-5D) score were assessed at study enrolment and at one, three, and six months after surgery. The survival times and complications were also collected. Results In total, 65 patients were aged < 70 years (mean 59.6 years; 32 to 69) and 36 patients were aged ≥ 70 years (mean 75.9 years; 70 to 90). In both groups, the PS improved from PS3 to PS1 by spine surgery, the mean BI improved from < 60 to > 80 points, and the mean EQ-5D score improved from 0.0 to > 0.7 points. However, no significant differences were found in the improvement rates and values of the PS, BI, and EQ-5D score at any time points between the two groups. The PS, BI, and EQ-5D score improved throughout the follow-up period in approximately 90% of patients in each group. However, the improved PS, BI, and EQ-5D scores subsequently deteriorated in some patients, and the redeterioration rate of the EQ-5D was significantly higher in patients aged ≥ 70 than < 70 years (p = 0.027). Conclusion Palliative surgery for spinal metastases improved the PS, activities of daily living, and quality of life, regardless of age. However, clinicians should be aware of the higher risk of redeterioration of the quality of life in advanced-age patients. Cite this article: Bone Joint J 2020;102-B(12):1709–1716.

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Vertebral compression fracture rate following stereotactic ablative body radiotherapy for spine oligometastases: a UK experience

Journal of Radiotherapy in Practice ◽

10.1017/s1460396921000224 ◽

2021 ◽

pp. 1-5

Author(s):

Sameed Hussain ◽

Anjali Zarkar ◽

Ahmed Elmodir ◽

Daniel Ford ◽

Sundus Yahya ◽

...

Keyword(s):

Vertebral Compression Fracture ◽

Demographic Data ◽

Spinal Metastases ◽

Compression Fracture ◽

Spinal Instability ◽

Fracture Rate ◽

Strict Adherence ◽

Stereotactic Ablative Body Radiotherapy ◽

Vertebral Bodies ◽

Pre Treatment

Abstract Aim: Stereotactic ablative body radiotherapy (SABR) for spine metastases is associated with a risk of vertebral compression fracture (VCF). The aim of this study was to determine the rate of VCF at one UK institution and evaluate the use of the Spinal Instability Neoplastic Score (SINS) to predict these. Materials and methods: A retrospective analysis of all patients who underwent SABR for spinal metastases between 2014 and 2018 at one UK institution was performed. Basic demographic data were collected, and SINS prior to SABR was calculated. The primary outcome was VCF rate. Secondary outcomes included time to VCF and need for surgical intervention following VCF. Results: A total of 48 oligometastases were treated with a median follow-up of 20·5 months. A maximum of two vertebral bodies were treated. The median baseline SINS was calculated as 3. The median dose was 26 Gy in three fractions. Two patients were reported to have VCF and both were successfully conservatively managed. Findings: SABR for spine oligometastases is being performed safely with low VCF rates which are comparable with those in international publications. This may be as a result of strict adherence to criteria for delivery of SABR with low pre-treatment SINS.

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