Skip to main content

Advertisement

SpringerLink
Log in

Prognostische Scores bei Wirbelsäulenmetastasen

Prognosis scores for spinal metastases

  • Leitthema
  • Published:
Der Orthopäde Aims and scope Submit manuscript

Zusammenfassung

Fortschritte in Diagnostik und Therapie haben zu einer Verbesserung der Überlebenszeit bei verschiedenen Tumorentitäten geführt. Dies und die demographische Entwicklung führen zu einer Zunahme von Metastasen, auch an der Wirbelsäule. In der Vergangenheit konnte eine Reihe von Prognosefaktoren identifiziert werden, die orientierende Aussagen über die zu erwartende Lebenszeit von Patienten mit Wirbelsäulenmetastasen erlauben. Auf dieser Grundlage wurden verschiedene Scores implementiert, welche verwendet werden, um im individuellen Fall Entscheidungen über Sinn und Ausmaß operativer Maßnahmen bei Wirbelsäulenmetastasen treffen zu können. In der vorgestellten Arbeit wird eine Übersicht über die Prognosefaktoren sowie die verwendeten Scores bei Wirbelsäulenmetastasen gegeben.

Abstract

Advances in early detection and therapy of spinal metastasis have improved life expectancy of patients with various tumor entities. However, this and the demographic development have led to an increased risk for developing spinal metastases. Numerous prognostic factors have been determined to allow an assessment of outcome and survival time of patients with metastatic spinal tumors. The implementation of these factors into different scoring systems has been encouraging in the decision making process of spinal surgery. This overview highlights some of the most important prognostic factors and scores which may facilitate surgical considerations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2

Literatur

  1. Aziz NM (2007) Cancer survivorship research: state of knowledge, challenges and opportunities. Acta Oncol 46:417–432

    Article  PubMed  Google Scholar 

  2. Balain B, Jaiswal A, Trivedi JM et al (2013) The Oswestry risk index: an aid in the treatment of metastatic disease of the spine. Bone Joint J 95-B:210–216

    Google Scholar 

  3. Bauer HC, Wedin R (1995) Survival after surgery for spinal and extremity metastases. Prognostication in 241 patients. Acta Orthop Scand 66:143–146

    Article  PubMed  CAS  Google Scholar 

  4. Bickels J, Dadia S, Lidar Z (2009) Surgical management of metastatic bone disease. J Bone Joint Surg [Am] 91:1503–1516

    Google Scholar 

  5. Boriani S, Weinstein JN, Biagini R (1997) Primary bone tumors of the spine. Terminology and surgical staging. Spine 22:1036–1044

    Article  PubMed  CAS  Google Scholar 

  6. Boriani S, Bandiera S, Biagini R et al (2006) Chordoma of the mobile spine: fifty years of experience. Spine 31:493–503

    Article  PubMed  Google Scholar 

  7. Choi D, Crockard A, Bunger C et al (2010) Review of metastatic spine tumour classification and indications for surgery: the consensus statement of the Global Spine Tumour Study Group. Eur Spine J 19:215–222

    Article  PubMed  Google Scholar 

  8. Choi M, Craft B, Geraci SA (2011) Surveillance and monitoring of adult cancer survivors. Am J Med 24:598–601

    Article  Google Scholar 

  9. Fisher CG, DiPaola CP, Ryken TC et al (2010) A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group. Spine 35:E1221–E1229

    Article  PubMed  Google Scholar 

  10. Fourney DR, Frangou EM, Ryken TC et al (2011) Spinal instability neoplastic score: an analysis of reliability and validity from the spine oncology study group. J Clin Oncol 29:3072–3077

    Article  PubMed  Google Scholar 

  11. Gasbarrini A, Li H, Cappuccio M et al (2010) Efficacy evaluation of a new treatment algorithm for spinal metastases. Spine 35:1466–1470

    PubMed  Google Scholar 

  12. Ghogawala Z, Mansfield FL, Borges LF (2001) Spinal radiation before surgical decompression adversely affects outcomes of surgery for symptomatic metastatic spinal cord compression. Spine 26:818–824

    Article  PubMed  CAS  Google Scholar 

  13. Harrington KD (1997) Orthopedic surgical management of skeletal complications of malignancy. Cancer 80:1614–1627

    Article  PubMed  CAS  Google Scholar 

  14. Huch K, Cakir B, Ulmar B et al (2005) Prognosis, surgical therapy and progression in cervical and upper-thoracic tumor osteolysis. Z Orthop Ihre Grenzgeb 143:213–218

    Article  PubMed  CAS  Google Scholar 

  15. Ibrahim A, Crockard A, Antonietti P et al (2008) Does spinal surgery improve the quality of life for those with extradural (spinal) osseous metastases? An international multicenter prospective observational study of 223 patients. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2007. J Neurosurg Spine 8:271–278

    Article  PubMed  Google Scholar 

  16. Jacobs WB, Perrin RG (2001) Evaluation and treatment of spinal metastases: an overview. Neurosurg Focus 11:e10

    Article  PubMed  CAS  Google Scholar 

  17. Jensen MP, Chen C, Brugger AM (2002) Postsurgical pain outcome assessment. Pain 99:101–109

    Article  PubMed  Google Scholar 

  18. Laufer I, Rubin DG, Lis E et al (2013) The NOMS framework: approach to the treatment of spinal metastatic tumors. Oncologist 18(6):744–751

    Article  PubMed  Google Scholar 

  19. Lee BH, Kim T-H, Chong H-S et al (2013) Prognostic factor analysis in patients with metastatic spine disease depending on surgery and conservative treatment: review of 577 cases. Ann Surg Oncol 20:40–46

    Article  PubMed  Google Scholar 

  20. Leithner A, Radl R, Gruber G et al (2008) Predictive value of seven preoperative prognostic scoring systems for spinal metastases. Eur Spine J 17:1488–1495

    Article  PubMed  Google Scholar 

  21. Mizumoto M, Harada H, Asakura H et al (2008) Prognostic factors and a scoring system for survival after radiotherapy for metastases to the spinal column: a review of 544 patients at Shizuoka Cancer Center Hospital. Cancer 113:2816–2822

    Article  PubMed  Google Scholar 

  22. Mollahoseini R, Farhan F, Khajoo A et al (2011) Is Tokuhashi score suitable for evaluation of life expectancy before surgery in Iranian patients with spinal metastases? J Res Med Sci 16:1183–1188

    PubMed  Google Scholar 

  23. Padalkar P, Tow B (2011) Predictors of survival in surgically treated patients of spinal metastasis. Indian J Orthop 45:307–313

    Article  PubMed  Google Scholar 

  24. Patchell RA, Tibbs PA, Regine WF et al (2005) Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet 366:643–648

    Article  PubMed  Google Scholar 

  25. Perrin RG, Laxton AW (2004) Metastatic spine disease: epidemiology, pathophysiology, and evaluation of patients. Neurosurg Clin North Am 15:365–373

    Article  Google Scholar 

  26. Sioutos PJ, Arbit E, Meshulam CF, Galicich JH (1995) Spinal metastases from solid tumors. Analysis of factors affecting survival. Cancer 76:1453–1459

    Article  PubMed  CAS  Google Scholar 

  27. Taneichi H, Kaneda K, Takeda N et al (1997) Risk factors and probability of vertebral body collapse in metastases of the thoracic and lumbar spine. Spine 22:239–245

    Article  PubMed  CAS  Google Scholar 

  28. Teixeira WGJ, Coutinho PR de M, Marchese LD et al (2013) Interobserver agreement for the spine instability neoplastic score varies according to the experience of the evaluator. Clinics (Sao Paulo) 68:213–218

  29. Tokuhashi Y, Matsuzaki H, Toriyama S et al (1990) Scoring system for the preoperative evaluation of metastatic spine tumor prognosis. Spine 15:1110–1113

    Article  PubMed  CAS  Google Scholar 

  30. Tokuhashi Y, Matsuzaki H, Oda H et al (2005) A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine 30:2186–2191

    Article  PubMed  Google Scholar 

  31. Tomita K, Kawahara N, Kobayashi T et al (2001) Surgical strategy for spinal metastases. Spine 26:298–306

    Article  PubMed  CAS  Google Scholar 

  32. Van der Linden YM, Dijkstra SPDS, Vonk EJA et al (2005) Prediction of survival in patients with metastases in the spinal column: results based on a randomized trial of radiotherapy. Cancer 103:320–328

    Article  Google Scholar 

  33. Wai EK, Finkelstein JA, Tangente RP et al (2003) Quality of life in surgical treatment of metastatic spine disease. Spine 28:508–512

    PubMed  Google Scholar 

  34. Wang JC, Boland P, Mitra N et al (2004) Single-stage posterolateral transpedicular approach for resection of epidural metastatic spine tumors involving the vertebral body with circumferential reconstruction: results in 140 patients. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004. J Neurosurg Spine 1:287–298

    Article  PubMed  Google Scholar 

  35. Weigel B, Maghsudi M, Neumann C et al (1999) Surgical management of symptomatic spinal metastases. Postoperative outcome and quality of life. Spine 24:2240–2246

    Article  PubMed  CAS  Google Scholar 

  36. Wibmer C, Leithner A, Hofmann G et al (2011) Survival analysis of 254 patients after manifestation of spinal metastases: evaluation of seven preoperative scoring systems. Spine 36:1977–1986

    Article  PubMed  Google Scholar 

  37. Wiedenhöfer B, Möhlenbruch M, Hemmer S et al (2012) Vertebral stability in management of spinal metastases. Criteria and strategies for operative interventions. Orthopade 41:623–631

    Article  PubMed  Google Scholar 

  38. Wise JJ, Fischgrund JS, Herkowitz HN et al (1999) Complication, survival rates, and risk factors of surgery for metastatic disease of the spine. Spine 24:1943–1951

    Article  PubMed  CAS  Google Scholar 

  39. Yamashita T, Siemionow KB, Mroz TE et al (2011) A prospective analysis of prognostic factors in patients with spinal metastases: use of the revised Tokuhashi score. Spine 36:910–917

    Article  PubMed  Google Scholar 

  40. Yilmazlar S, Dogan S, Caner B et al (2008) Comparison of prognostic scores and surgical approaches to treat spinal metastatic tumors: a review of 57 cases. J Orthop Surg Res 3:37

    Article  PubMed  Google Scholar 

  41. Zou X-N, Grejs A, Li H-S et al (2006) Estimation of life expectancy for selecting surgical procedure and predicting prognosis of extradural spinal metastases. Ai Zheng 25:1406–1410

    PubMed  Google Scholar 

Download references

Einhaltung der ethischen Richtlinien

Interessenkonflikt. Der korrespondierende Autor N. von der Höh gibt für sich und seine Koautoren J. Gulow, S.K. Tschöke, A. Völker, C.E. Heyde an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Author information

Authors and Affiliations

  1. Orthopädische Klinik und Poliklinik, Universität Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland

    N.H. von der Höh, J. Gulow, A. Völker & C.E. Heyde

  2. Abteilung für Wirbelsäulenchirurgie, Park-Krankenhaus Leipzig, Leipzig, Deutschland

    S.K. Tschöke

Authors
  1. N.H. von der Höh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Gulow
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S.K. Tschöke
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Völker
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. C.E. Heyde
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N.H. von der Höh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

von der Höh, N., Gulow, J., Tschöke, S. et al. Prognostische Scores bei Wirbelsäulenmetastasen. Orthopäde 42, 725–733 (2013). https://doi.org/10.1007/s00132-013-2067-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00132-013-2067-3

Schlüsselwörter

Keywords

Search

Navigation