The Neurology-Stability-Epidural compression assessment: A new score to establish the need for surgery in spinal metastases.

Clinical Neurology and Neurosurgery
F CofanoDiego Garbossa

Abstract

The aim of this study was to translate new evidence about management of spinal metastases in a practical and reliable score for surgeons, radiation oncologists and oncologists, able to establish the need for surgery regardless the available technology and settings. Three main items were identified and graded: Neurological status (0-5 points), Stability of the spine according to the Spinal Instability Neoplastic Score (SINS) Score (0-5 points), and Epidural compression according to the Epidural Spinal Cord Compression (ESCC) scale (0-3 points). Patients were considered suitable for surgery with ASA score < 4 and ECOG score <3. A retrospective clinical validation of the NSE score was made on 145 patients that underwent surgical or non surgical treatment. Agreement between the undertaken treatment and the score (88.3% of patients), resulted in a strong association with improvement or preservation of clinical status (neurological functions and mechanical pain) (p < 0.001) at 3 and 6 months. In the non-agreement group no association was recorded at the 3 and 6 months follow-up (p 0.486 and 0.343 for neurological functions, 0.063 and 0.858 for mechanical pain). Functional outcomes of the study group showed that the proposed NSE score...Continue Reading

References

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Dec 24, 2019·Cancer Control : Journal of the Moffitt Cancer Center·Fabio CofanoDiego Garbossa

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Citations

Oct 23, 2020·Journal of Bone Oncology·Giuseppe Di PernaDiego Garbossa
Apr 14, 2021·Scientific Reports·Arthur WagnerBernhard Meyer
Apr 23, 2021·The Spine Journal : Official Journal of the North American Spine Society·Daniel M SciubbaUNKNOWN NASS Spine Oncology Committee
Apr 22, 2021·Surgical Neurology International·Bianca Maria BaldassarreDiego Garbossa

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