Asian Spine J.  2018 Oct;12(5):919-926. 10.31616/asj.2018.12.5.919.

Prognosis of Single Spinal Metastatic Tumors: Predictive Value of the Spinal Instability Neoplastic Score System for Spinal Adverse Events

• Chang SY
• Ha JH
• Seo SG
• Chang BS
• Lee CK
• Kim H

• KMID: 2426654
• DOI: http://doi.org/10.31616/asj.2018.12.5.919

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.

Keyword

Neoplasm metastasis; Spinal Instability Neoplastic Score; Compression fractures; Spinal cord compression

MeSH Terms

Cohort Studies
Diagnosis
Fractures, Compression
Humans
Multivariate Analysis
Neoplasm Metastasis
Prognosis*
Proportional Hazards Models
Retrospective Studies
Spinal Cord Compression
Survival Rate