gms | German Medical Science

72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

Article

Send article

Utility of the spinal instability score in patients with spinal metastases – a single-centre study with 332 patients

Die Nützlichkeit des „Spinal Instability Score“ für Patienten mit Wirbelkörpermetastasen – eine monozentrische Studie mit 332 Patienten

Meeting Abstract

Search Medline for

  • presenting/speaker Maximilian-Niklas Bonk - Universitätsklinikum Augsburg, Klinik für Neurochirurgie, Augsburg, Deutschland
  • Björn Sommer - Universitätsklinikum Augsburg, Klinik für Neurochirurgie, Augsburg, Deutschland
  • Bastian Stemmer - Universitätsklinikum Augsburg, Klinik für Neurochirurgie, Augsburg, Deutschland
  • Stefan Motov - Universitätsklinikum Augsburg, Klinik für Neurochirurgie, Augsburg, Deutschland
  • Christina Wolfert - Universitätsklinikum Augsburg, Klinik für Neurochirurgie, Augsburg, Deutschland
  • Björn Hackanson - Universitätsklinikum Augsburg, II. Medizinische Klinik, Augsburg, Deutschland
  • Klaus-Henning Kahl - Universitätsklinikum Augsburg, Klinik für Strahlentherapie und Radioonkologie, Augsburg, Deutschland
  • Georg Stüben - Universitätsklinikum Augsburg, Klinik für Strahlentherapie und Radioonkologie, Augsburg, Deutschland
  • Christoph Schmid - Universitätsklinikum Augsburg, II. Medizinische Klinik, Augsburg, Deutschland
  • Martin Trepel - Universitätsklinikum Augsburg, II. Medizinische Klinik, Augsburg, Deutschland
  • Bruno Märkl - Universitätsklinikum Augsburg, Institut für Pathologie und Molekulare Diagnostik, Augsburg, Deutschland
  • Ehab Shiban - Universitätsklinikum Augsburg, Klinik für Neurochirurgie, Augsburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV287

doi: 10.3205/21dgnc272, urn:nbn:de:0183-21dgnc2729

Published: June 4, 2021

© 2021 Bonk et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Spinal metastases may cause spinal instability. The Spinal Instability Neoplastic Score (SINS) was developed to assess spinal neoplastic-related instability. Aim of this study was to determine the utility of SINS in predicting progression of a pathologic fracture due to spinal metastases.

Methods: A retrospective analysis of patients with a pathologic fracture due to a spinal metastases between January 2018 and December 2018 was performed. We selected patients with a minimum follow-up of 12 months and analysed them according to the SINS criteria. The primary endpoint was the progression of vertebral body fracture following radiotherapy.

Results: 332 Patients were identified. Median age was 68 SD +/- 10,3. 38% were female. Median follow-up was 26 months (range 12-29). 30, 283 and 19 patients presented with low (0-6), moderate (7-12) and high (13-18) SINS, respectively. Fracture progression following radiotherapy was seen in 9 (30%), 84 (30%) and 8 (42%) in cases with low, moderate, or high SINS (P = 0.522), respectively. During follow-up, 44% of patients with low SINS showed a progression to moderate SINS without neurological deficits. In the originally moderate group, 17% had progression with neurological deficits needing surgery. None had functional recovery postoperatively. 83% of the progression cases in the moderate group did not develop neurological deficits and 4 underwent surgery for pain management. 63% of all progressions in the high group developed neurological deficits, however none of them recovered postoperatively (P < 0.001).

Conclusion: SINS is a very useful tool for assess stability of a pathologic fracture due to spinal metastases after radiotherapy for spinal metastases. Moderate or high SINS are associated with a high risk of fracture progression as well as risk for neurological deterioration, therefore surgical instrumentation in these groups may be advised prior to radiotherapy.