Protein S-100b as serum marker for prediction of functional outcome in metastatic spinal cord compression

Summary

Background. To evaluate the significance of protein S-100b as a serum marker for the prediction of functional outcome in the event of symptomatic spinal cord compression due to epidural metastases.

Method. 34 patients with paresis due to metastatic spinal cord compression were included in this prospective study. Venous blood samples for protein S-100b were taken after admission and regularly after operative decompression. The individual time course of protein S-100b levels was correlated with the clinical outcome by means of motor function. Outcome was considered to be favourable in case of neurological improvement and preservation or retrieval of walking ability whereas non-improvement or further neurological deterioration without restoration of function of ambulation was regarded to be unfavourable.

Findings. Patients with favourable outcome had serum levels of S-100b which were either normal all the time or which were initially increased but normalised within 2 to 3 days. Patients with unfavourable outcome, however, had increased levels throughout which showed either a further increase or only a slow decrease within approximately two weeks (p=0.0001).

Interpretation. These preliminary results suggest that, analogous to cerebral disorders, protein S-100b might be a promising serum marker to predict functional outcome in symptomatic spinal cord compression.