A validation of the Oswestry Spinal Risk Index

Whitehouse, S.; Stephenson, John; Sinclair, V.; Gregory, Jeremy; Tambe, Anant; Verma, Rajat; Siddique, Irfan; Mohammad, Saeed

doi:10.1007/s00586-014-3665-4

Cited by 10 publications

(3 citation statements)

References 13 publications

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“…Whitehouse et al and Fleming et al both applied the OSRI to 100 and 121 patients, respectively, and found that the newly established risk index held true when tested on independent cohorts. 42,43 The attractiveness of the OSRI is its simplicity with only 2 key factors considered and it does not rely on a full imaging workup.…”

Section: Overview Of Scoring Systems and Selection Criteria For Detaimentioning

confidence: 99%

The Role of Prognostic Scoring Systems in Assessing Surgical Candidacy for Patients With Vertebral Metastasis: A Narrative Review

Cassidy

Baker

Lenehan

2018

Global Spine Journal

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Study Design:Narrative review.Objectives:To review the relevant literature regarding scoring systems for vertebral metastases and quantify their role in contemporary orthopedic practice.Methods:A literature search of PubMed, Google Scholar, and Embase was performed on February 7, 2017. Eight scoring systems were selected for detailed review—7 of which were scores focused solely on patient prognosis (Tokuhashi, Tomita, Bauer, Oswestry Spinal Risk Index, Van der Linden, Rades, and Katagiri). The eighth system reviewed was the Spinal Instability Neoplastic Score, which examines for impending spinal instability in patients with vertebral metastases and represents a novel approach compared with hitherto scoring systems.Results:The Bauer and Oswestry Spinal Risk Index have the most accurate prognostic predictive ability, with the newer Oswestry Spinal Risk Index being favored by the contemporary literature as it demands less investigation and is therefore more readily accessible. There was a growing trend in studies designed to customize scoring systems for individual cancer pathological subtypes. The Spinal Instability Neoplastic Score shows good reliability for predicting instability among surgeons and oncologists.Conclusions:The increased understanding of cancer pathology and subsequent development of customized treatments has led to prolonged survival. For patients with vertebral metastases, this affects surgical candidacy not only on the basis of prognosis but also provides prolonged opportunity for the development of spinal instability. Scoring systems have a useful guidance role in these deciding for/against surgical intervention, but in order to remain contemporary ongoing review, development, and revalidation is mandatory.

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Section: Overview Of Scoring Systems and Selection Criteria For Detaimentioning

confidence: 99%

The Role of Prognostic Scoring Systems in Assessing Surgical Candidacy for Patients With Vertebral Metastasis: A Narrative Review

Cassidy

Baker

Lenehan

2018

Global Spine Journal

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“…The Oswestry Spinal Risk Index (OSRI) is a simple, reproducible measure of survivorship looking at primary tumor pathology and the patient’s general condition[26]. It has been externally validated twice and provides accurate prediction of a patients survivorship which can be used in the decision making process[27,28]. …”

Section: Stability With Spinal Metastasismentioning

confidence: 99%

Sternal metastasis - the forgotten column and its effect on thoracic spine stability

Piggott¹,

Curtin²,

Munigangaiah³

et al. 2017

WJO

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Sternal metastases are not studied extensively in the literature. There is a paucity of information on their role in metastatic disease. The concept of the fourth column was described by Berg in 1993, and has been proven in case report, clinically and biomechanical studies. The role of the sternum as a support to the thoracic spine is well documented in the trauma patients, but not much is known about its role in cancer patients. This review examines what is known on the role of the fourth column. Following this we have identified two likely scenarios that sternal metastases may impact management: (1) sternal pathological fracture increases the mobility of the semi-rigid thorax with the loss of the biomechanical support of the sternum-rib-thoracic spine complex; and (2) a sternal metastasis increases the risk of fracture, and while being medical treated the thoracic spine should be monitored for acute kyphosis and neurological injury secondarily to the insufficiency of the fourth column.

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“…22 These prediction models have been internally and externally validated. [23][24][25][26][27][28] However, results of those external validation efforts are inconsistent. 29 The goal of this study was to develop and internally validate a novel model to optimize surgical decisionmaking in our population and to externally validate the OSRI and modified Bauer score models in our center.…”

Section: Introductionmentioning

confidence: 99%

Predicting Survival in Patients Presenting With Spinal Epidural Metastases: The Limburg Spinal Metastasis Score

et al. 2023

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Background: Patients with spinal epidural metastases (SEM) often experience a reduction in ambulatory status and, thus, the quality of life. Predicting which patients will benefit from a surgical intervention remains a challenge. Life expectancy is an essential factor to be considered in surgical decision-making, although not the only one. Prediction models can add value in surgical decision-making. The goal of this study was to develop and internally validate a novel model (Limburg spinal metastases score [LSMS]) and compare the predictive value with 2 commonly used models: modified Bauer score and Oswestry Spinal Risk Index (OSRI).Methods: We retrospectively analyzed 144 consecutive patients who underwent surgical decompression for SEM in our centers between November 2006 and December 2020. Clinical and surgical parameters were evaluated. The novel prediction model was based on multivariate analysis and was internally validated. External validation of the 2 most commonly used prediction models was performed.Results: The median survival was 17 months, 55.7% of the immobile patients regained ambulation postoperatively. In 50 patients (34.7%), at least 1 complication occurred within 30 days after surgery. The LSMS consists of 4 parameters: primary tumor type, Karnofsky performance score, presence of visceral metastases, and presence of multiple spinal metastases. Bootstrap internal validation of the model developed on this cohort yielded an optimism-corrected c-statistic of 0.75 (95% CI: 0.71-0.80). The c-statistic of the OSRI score and the Bauer score was 0.69 (95% CI: 0.64-0.74) and 0.67 (95% CI: 0.62-0.72), respectively. Conclusion:The LSMS consists of 4 parameters to assist surgical decision-making for patients with SEM. The score is easy to use and appears more accurate in our population in comparison with previous existing models.Clinical Relevance: A novel prediction model was developed to aid in surgical decision-making for patients with spinal epidural metastases.Level of Evidence: 3.

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A validation of the Oswestry Spinal Risk Index

Cited by 10 publications

References 13 publications

The Role of Prognostic Scoring Systems in Assessing Surgical Candidacy for Patients With Vertebral Metastasis: A Narrative Review

The Role of Prognostic Scoring Systems in Assessing Surgical Candidacy for Patients With Vertebral Metastasis: A Narrative Review

Sternal metastasis - the forgotten column and its effect on thoracic spine stability

Predicting Survival in Patients Presenting With Spinal Epidural Metastases: The Limburg Spinal Metastasis Score

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