10-Year Trends in the Surgical Management of Patients with Spinal Metastases: A Scoping Review

Orenday-Barraza, José Manuel; Cavagnaro, María José; Avila, Mauricio J.; Strouse, Isabel Martha; Dowell, Aaron; Kisana, Haroon; Khan, Naushaba; Ravinsky, Robert; Baaj, Ali A.

doi:10.1016/j.wneu.2021.10.086

Cited by 16 publications

(14 citation statements)

References 81 publications

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“…Cement augmentation achieved pain reduction rates of 56-100%, neurologic improvement/stability 84-100%, and complication rates 6-56%. Laser achieved local tumor control rate of 71-82% at 1-year follow-up, reoperation rate of 15-31%, and complication rate of 5-26% (58).…”

Section: Surgical Complicationsmentioning

confidence: 90%

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Ten Years After SINS: Role of Surgery and Radiotherapy in the Management of Patients With Vertebral Metastases

Serratrice¹,

Faddoul

Tarabay³

et al. 2022

Front. Oncol.

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The objective of the different types of treatments for a spinal metastasis is to provide the best oncological and functional result with the least aggressive side effects. Initially created in 2010 to help clinicians in the management of vertebral metastases, the Spine Instability Neoplastic Score (SINS) has quickly found its place in the decision making and the treatment of patients with metastatic spinal disease. Here we conduct a review of the literature describing the different changes that occurred with the SINS score in the last ten years. After a brief presentation of the spinal metastases’ distribution, with or without spinal cord compression, we present the utility of SINS in the radiological diagnosis and extension of the disease, in addition to its limits, especially for scores ranging between 7 and 12. We take this opportunity to expose the latest advances in surgery and radiotherapy concerning spinal metastases, as well as in palliative care and pain control. We also discuss the reliability of SINS amongst radiologists, radiation oncologists, spine surgeons and spine surgery trainees. Finally, we will present the new SINS-derived predictive scores, biomarkers and artificial intelligence algorithms that allow a multidisciplinary approach for the management of spinal metastases.

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Section: Surgical Complicationsmentioning

confidence: 90%

“…When possible, minimally invasive techniques for decompression and stabilization seem to be the preferred method to surgically treat metastatic spine disease, with good outcomes (58). For separation surgery, clinical outcomes were overall 1-year survival, 41-78%; recurrence rate, 4-22%; reoperation, 5%; and complications, 5-14%.…”

Section: Surgical Complicationsmentioning

confidence: 99%

Ten Years After SINS: Role of Surgery and Radiotherapy in the Management of Patients With Vertebral Metastases

Serratrice¹,

Faddoul

Tarabay³

et al. 2022

Front. Oncol.

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“…A plane is created between the tumour at the posterior vertebral body and the thecal sac, with a minimum space of 3 mm, allowing for the safe delivery of postoperative SRS. 96 This technique can be achieved via both minimal access and open spinal surgery. Evidence suggests that hybrid therapy yields an excellent outcome in local tumour control, with a recurrence rate of 4.3 to 22%.…”

Section: Surgical Managementmentioning

confidence: 99%

“…Evidence suggests that hybrid therapy yields an excellent outcome in local tumour control, with a recurrence rate of 4.3 to 22%. 96 The overall 1-year survival after surgery is reported to be up to 78.4%. 96 The rate of complications and reoperations are reported as 5.4–14% and 5%, respectively.…”

Section: Surgical Managementmentioning

confidence: 99%

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Spinal metastasis: narrative reviews of the current evidence and treatment modalities

Jaipanya

Chanplakorn

2022

J Int Med Res

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The treatment for spinal metastasis has evolved significantly during the past decade. An advancement in systemic therapy has led to a prolonged overall survival in cancer patients, thus increasing the incidence of spinal metastasis. In addition, with the improved treatment armamentarium, the prediction of patient survival using traditional prognostic models may have limitations and these require the incorporation of some novel parameters to improve their prognostic accuracy. The development of minimally-invasive spinal procedures and minimal access surgical techniques have facilitated a quicker patient recovery and return to systemic treatment. These modern interventions help to alleviate pain and improve quality of life, even in candidates with a relatively short life expectancy. Radiotherapy may be considered in non-surgical candidates or as adjuvant therapy for improving local tumour control. Stereotactic radiosurgery has facilitated this even in radioresistant tumours and may even replace surgery in radiosensitive malignancies. This narrative review summarizes the current evidence leading to the paradigm shifts in the modern treatment of spinal metastasis.

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Patients with progression of spinal metastases who present to the clinic have better outcomes compared to those who present to the emergency department

Linzey,

Kathawate,

Strong

et al. 2023

Cancer Medicine

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BackgroundAs cancer therapies have improved, spinal metastases are increasingly common. Resulting complications have a significant impact on patient's quality of life. Optimal methods of surveillance and avoidance of neurologic deficits are understudied. This study compares the clinical course of patients who initially presented to the emergency department (ED) versus a multidisciplinary spine oncology clinic and who underwent stereotactic body radiation therapy (SBRT) secondary to progression/presentation of metastatic spine disease.MethodsWe performed a retrospective analysis of a prospectively maintained database of adult oncologic patients who underwent spinal SBRT at a single hospital from 2010 to 2021. Descriptive statistics and survival analyses were performed.ResultsWe identified 498 spinal radiographic treatment sites in 390 patients. Of these patients, 118 (30.3%) presented to the ED. Patients presenting to the ED compared to the clinic had significantly more severe spinal compression (52.5% vs. 11.7%; p < 0.0001), severe pain (28.8% vs. 10.3%; p < 0.0001), weakness (24.5% vs. 4.5%; p < 0.0001), and difficulty walking (24.5% vs. 4.5%; p < 0.0001). Patients who presented to the ED compared to the clinic were significantly more likely to have surgical intervention followed by SBRT (55.4% vs. 15.3%; p < 0.0001) compared to SBRT alone. Patients who presented to the ED compared to the clinic had a significantly quicker interval to distant spine progression (5.1 ± 6.5 vs. 9.1 ± 10.2 months; p = 0.004), systemic progression (5.1 ± 7.2 vs. 9.2 ± 10.7 months; p < 0.0001), and worse overall survival (9.3 ± 10.0 vs. 14.3 ± 13.7 months; p = 0.002).ConclusionThe establishment of multidisciplinary spine oncology clinics is an opportunity to potentially allow for earlier, more data‐driven treatment of their spinal metastatic disease.

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10-Year Trends in the Surgical Management of Patients with Spinal Metastases: A Scoping Review

Cited by 16 publications

References 81 publications

Ten Years After SINS: Role of Surgery and Radiotherapy in the Management of Patients With Vertebral Metastases

Ten Years After SINS: Role of Surgery and Radiotherapy in the Management of Patients With Vertebral Metastases

Spinal metastasis: narrative reviews of the current evidence and treatment modalities

Patients with progression of spinal metastases who present to the clinic have better outcomes compared to those who present to the emergency department

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