Anne L Versteeg1, Arjun Sahgal2, Ilya Laufer3, Laurence D Rhines4, Daniel M Sciubba5, James M Schuster6, Michael H Weber7, Aron Lazary8, Stefano Boriani9, Chetan Bettegowda5, Michael G Fehlings10, Michelle J Clarke11, Paul M Arnold12, Ziya L Gokaslan13, Charles G Fisher14. 1. Division of Surgery, Department of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada. 2. Department of Radiation Oncology, Sunnybrook Odette Cancer Centre and University of Toronto, Toronto, Ontario, Canada. 3. Division of Spinal Neurosurgery, Department of Neurosurgery, NYU Langone Langone Health, New York, NY, USA. 4. Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 5. Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 6. Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. 7. Division of Surgery, McGill University and Montreal General Hospital, Montreal, Quebec, Canada. 8. National Center for Spinal Disorders and Buda Health Center, Budapest, Hungary. 9. GSpine4 Spine Surgery Division, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. 10. Division of Neurosurgery and Spine Program, University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada. 11. Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA. 12. Department of Neurosurgery, Carle Foundation Hospital, Urbana, IL, USA. 13. Department of Neurosurgery, The Warren Alpert Medical School of Brown University and Rhode Island Hospital and The Miriam Hospital, Providence, RI, USA. 14. Division of Spine, Department of Orthopaedics, University of British Columbia and Vancouver General Hospital, Vancouver, British Columbia, Canada.
Abstract
STUDY DESIGN: International multicenter prospective observational cohort study on patients undergoing radiation +/- surgical intervention for the treatment of symptomatic spinal metastases. OBJECTIVES: To investigate the association between the total Spinal Instability Neoplastic Score (SINS), individual SINS components and PROs. METHODS: Data regarding patient demographics, diagnostics, treatment, and PROs (SF-36, SOSGOQ, EQ-5D) was collected at baseline, 6 weeks, and 12 weeks post-treatment. The SINS was assessed using routine diagnostic imaging. The association between SINS, PRO at baseline and change in PROs was examined with the Spearmans rank test. RESULTS: A total of 307 patients, including 174 patients who underwent surgery+/- radiotherapy and 133 patients who underwent radiotherapy were eligible for analyses. In the surgery+/- radiotherapy group, 18 (10.3%) patients with SINS score between 0-6, 118 (67.8%) with a SINS between 7-12 and 38 (21.8%) with a SINS between 13-18, as compared to 55 (41.4%) SINS 0-6, 71(53.4%) SINS 7-12 and 7 (5.2%) SINS 13-18 in the radiotherapy alone group. At baseline, the total SINS and the presence of mechanical pain was significantly associated with the SOSGOQ pain domain (r = -0.519, P < 0.001) and the NRS pain score (r = 0.445, P < 0.001) for all patients. The presence of mechanical pain demonstrated to be moderately associated with a positive change in PROs at 12 weeks post-treatment. CONCLUSION: Spinal instability, as defined by the SINS, was significantly correlated with PROs at baseline and change in PROs post-treatment. Mechanical pain, as a single SINS component, showed the highest correlations with PROs.
STUDY DESIGN: International multicenter prospective observational cohort study on patients undergoing radiation +/- surgical intervention for the treatment of symptomatic spinal metastases. OBJECTIVES: To investigate the association between the total Spinal Instability Neoplastic Score (SINS), individual SINS components and PROs. METHODS: Data regarding patient demographics, diagnostics, treatment, and PROs (SF-36, SOSGOQ, EQ-5D) was collected at baseline, 6 weeks, and 12 weeks post-treatment. The SINS was assessed using routine diagnostic imaging. The association between SINS, PRO at baseline and change in PROs was examined with the Spearmans rank test. RESULTS: A total of 307 patients, including 174 patients who underwent surgery+/- radiotherapy and 133 patients who underwent radiotherapy were eligible for analyses. In the surgery+/- radiotherapy group, 18 (10.3%) patients with SINS score between 0-6, 118 (67.8%) with a SINS between 7-12 and 38 (21.8%) with a SINS between 13-18, as compared to 55 (41.4%) SINS 0-6, 71(53.4%) SINS 7-12 and 7 (5.2%) SINS 13-18 in the radiotherapy alone group. At baseline, the total SINS and the presence of mechanical pain was significantly associated with the SOSGOQ pain domain (r = -0.519, P < 0.001) and the NRS pain score (r = 0.445, P < 0.001) for all patients. The presence of mechanical pain demonstrated to be moderately associated with a positive change in PROs at 12 weeks post-treatment. CONCLUSION: Spinal instability, as defined by the SINS, was significantly correlated with PROs at baseline and change in PROs post-treatment. Mechanical pain, as a single SINS component, showed the highest correlations with PROs.
Authors: Moritz Lenschow; Maximilian Lenz; Niklas von Spreckelsen; Julian Ossmann; Johanna Meyer; Julia Keßling; Lukas Nadjiri; Sergej Telentschak; Kourosh Zarghooni; Peter Knöll; Moritz Perrech; Eren Celik; Max Scheyerer; Volker Neuschmelting Journal: Cancers (Basel) Date: 2022-04-27 Impact factor: 6.575
Authors: Grace X Xiong; Miles W A Fisher; Joseph H Schwab; Andrew K Simpson; Lananh Nguyen; Daniel G Tobert; Tracy A Balboni; John H Shin; Marco L Ferrone; Andrew J Schoenfeld Journal: Spine (Phila Pa 1976) Date: 2022-04-01 Impact factor: 3.468