Liaison Treatment for Metastatic Spinal Tumors

Abstract

16we were able to detect the spinal tumor before a significant breakdown of the spinal support 17 system. Ninety-five percent of patients were classified according to the Frankel grade 18 classification during their initial diagnosis, and many patients initially underwent treatment 19 before the onset of paralysis. Of patients with an SRE, 33% were Frankel grade E, indicating 20 that approximately half were paralyzed at initial diagnosis. The median survival duration was 21 prolonged by approximately 9 months in patients without an SRE compared with those with an 22 SRE. 23 Conclusions 24 Orthopedic spine surgeons are responsible for maintaining activities of daily living, improving 25 quality of life, and prolonging life expectancy in patients with metastatic spinal tumors. The 126 Tokyo, Japan), with a significance level of 5%. Between-group differences in baseline 127 characteristics and clinical outcomes were assessed using the Mann-Whitney U test. 128 129 Results 130As presented in Fig. 2, most primary tumor sites were in the breast, lung, or prostate. 131The average age did not differ significantly between patients with and without an SRE (Table 132 2). In terms of prognosis evaluation, only the Tokuhashi score differed significantly between the 133 two groups (P ≤ 0.01). In most patients without an SRE, the average SINS was 5.2, indicating

Effect of Minimally Invasive Spine Stabilization in Metastatic Spinal Tumors

“…At our hospital, 31 of 51 patients were discharged home after surgery (mean 31.9 ± 18.0 days after surgery), and 17 were transferred to another institution (mean 39.4 ± 7.0 days after surgery). The reason why our hospital stay was longer than other reports was that the primary physician for the hospital stay was basically the oncologist, not the orthopedic surgeon, due to multidisciplinary treatment [ 6 ]. The advantage was that the oncology department could start treatment as soon as possible, while the primary physician had a long hospital stay to introduce other adjuvant therapies after the surgery.…”

“…It is also important to detect the disease at an early stage by using multidisciplinary treatment, as in this study. Our results are due to the fact that we intervene early in all metastatic spine tumors [ 6 ]. Rather than providing palliative or urgent treatment to all patients, it is advisable to detect candidate patients as early as possible and to restore spine-related functions with less invasive surgery before these functions are lost and neurological symptoms occur.…”

“…We provided multidisciplinary therapeutic intervention for all metastatic spine tumors [ 6 ]. Once metastasis was detected in the spine, the spinal surgeon intervened to determine the treatment plan.…”

“…(3) time to ambulation; (4) Tokuhashi score [10] and New Katagiri score [11] to evaluate prognosis; (5) SINS to evaluate the stability of the vertebral body [7]; (6) Frankel grade to assess the degree of spinal cord injury; and (7) Eastern Cooperative Oncology Group Performance status (PS) [12] to evaluate QOL. The association of each parameter with the outcome was assessed using the Mann-Whitney U test, and survival time was calculated from the date of enrollment to the date of death using the Kaplan-Meier method.…”

A new era in the management of spinal metastasis

“…Multidisciplinary approaches are reported to have a key role in patients with spinal metastases as they might lead to earlier recognition of a neurological deficit, initiation of radiological investigations, and treatment ( 33 ) Preservation of walking ability can be achieved by using radiotherapy for spinal cord metastases before walking function declines ( 19 , 34 ), fractures and paralysis can be prevented through early detection of bone metastases via imaging surveillance even in the absence of subjective symptoms ( 20 , 35 ), and paralysis as well as surgery can be prevented by timely interventions of a liaison team before SREs occur ( 21 , 26 ). Maintaining the ability to walk at the terminal stage (30 days prior to death) ( 21 ), reduced costs and hospitalization ( 10 – 16 ), and improvement of the rate and severity of neurological impairment subsequent to local treatment ( 26 ). These ultimately improvement the overall survival ( 26 , 32 , 36 ).…”