A Comparison of the Tomita and Tokuhashi Scores in Spinal Metastasis

Candido, P.; Perria, Fernanda Maria; Costa, Herton Rodrigo Da; Defino, Helton Luíz Aparecido

doi:10.1590/s1808-185120201904238102

Cited by 2 publications

(1 citation statement)

References 26 publications

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“…Different series comparing the Tomita and the modified Tokuhashi scores accuracy in retrospectively determining prognosis for patients afflicted with spinal metastases have shown a higher prognostic power of both scores for patients with less than six months’ survival and a global better prognostic accuracy of the modified Tokuhashi score [ 88 , 89 ].…”

Section: The Art Of Prognostication Clinical Judgment and Decisionmentioning

confidence: 99%

Multidisciplinary Approach to Spinal Metastases and Metastatic Spinal Cord Compression—A New Integrative Flowchart for Patient Management

Esperança-Martins

Roque

Barroso

et al. 2023

Cancers

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Metastatic spine disease (MSD) and metastatic spinal cord compression (MSCC) are major causes of permanent neurological damage and long-term disability for cancer patients. The development of MSD is pathophysiologically framed by a cooperative interaction between general mechanisms of bone growth and specific mechanisms of spinal metastases (SM) expansion. SM most commonly affects the thoracic spine, even though multiple segments may be affected concomitantly. The great majority of SM are extradural, while intradural-extramedullary and intramedullary metastases are less frequently seen. The management of patients with SM is particularly complex and challenging, with multiple factors—such as the spinal stability status, primary tumor radio and chemosensitivity, cancer biological burden, patient performance status and comorbidities, and patient’s oncological prognosis—influencing the clinical decision-making process. Different frameworks were developed in order to systematize and support this process. A multidisciplinary, personalized approach, enriched by the expertise of each involved specialty, is crucial. We reviewed the most recent evidence and proposed an updated algorithmic approach to patients with MSD according to the clinical scenario of each patient. A flowchart-based approach offers an evidence-based management of MSD, providing a valuable clinical decision tool in a context of high uncertainty and quick-acting need.

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Section: The Art Of Prognostication Clinical Judgment and Decisionmentioning

confidence: 99%

Multidisciplinary Approach to Spinal Metastases and Metastatic Spinal Cord Compression—A New Integrative Flowchart for Patient Management

Esperança-Martins

Roque

Barroso

et al. 2023

Cancers

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Rehabilitation Palliative Care for Metastatic Spinal Disease Based on Tokuhashi-Tomita Score: A Case Report

Hidayati

Yusviani

2022

IJAR

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Metastatic spinal disease is considered a terminal stage of primary cancer and palliative treatment focuses around symptom control and reducing spinal complications such as cord compression. A 60 years man with complete spinal cord injury AIS A post laminectomy with Th2-Th4 decompression and tumor biopsy due to canal stenosis et causa Th3 compression fracture. Patient has history of paraparesis in level Th4-Th8, also bladder and bowel incontinence. The prognosis of patients with epidural metastasis is not promising and difcult to predict. Tokuhashi and Tomita scores are one of tools that used widely to predict the patient’s survival prognosis, in particularly for spinal metastatic treatment decision. These scores provide guidance decision whether aggressive operative or palliative. Tokuhashi score in this patient indicated the survival rate was below 6 months and Tomita score referred to palliative treatment. Physical medicine and rehabilitation treatment focus on palliative treatment for this patient include diminished pain, maintain vertebral stability, improve physical tness and mobility to reduce further complication of prolonged bedridden and improve quality of life. Other treatment was given according to complaint and symptom. Patient was died less than 2-month post-surgery after readmission to the hospital due to bed ridden complications.

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A Comparison of the Tomita and Tokuhashi Scores in Spinal Metastasis

Cited by 2 publications

References 26 publications

Multidisciplinary Approach to Spinal Metastases and Metastatic Spinal Cord Compression—A New Integrative Flowchart for Patient Management

Multidisciplinary Approach to Spinal Metastases and Metastatic Spinal Cord Compression—A New Integrative Flowchart for Patient Management

Rehabilitation Palliative Care for Metastatic Spinal Disease Based on Tokuhashi-Tomita Score: A Case Report

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